NPIMap

Organization Active NPI

Holistic Health With Kelly LLC

  • Mental Health Counselor
  • Meridian, MS
National Provider Identifier
1245806041
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
HOLISTIC HEALTH WITH KELLY LLC
Practice address
6259 Pinedale Rd
Meridian, MS 39305-3430
Phone
(601) 616-3752
NPI assigned
Jun 2, 2021
Last updated
Jun 2, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kelly Harper Smith, LCSWNPI 1407346380
Title
Owner
Phone
(601) 616-3752

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

6259 Pinedale Rd
Meridian, MS 39305-3430

Mailing address

6259 Pinedale Rd
Meridian, MS 39305-3430
Phone (601) 616-3752

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210830002828 MS Part B Supplier - Clinic/Group Practice 1850797846 Receives reassigned benefits from 9 practitioners
Practice locations: Meridian, MS

National Provider Directory

National Provider Directory

Locations

2011 23rd Ave
Meridian, MS 39301
Phone (601) 286-5983

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622592000000",
    "number": "1245806041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6259 PINEDALE RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393053430",
            "telephone_number": "601-616-3752"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6259 PINEDALE RD",
            "city": "MERIDIAN",
            "state": "MS",
            "postal_code": "393053430",
            "telephone_number": "601-616-3752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC HEALTH WITH KELLY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "HARPER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-616-3752",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Meridian, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.