Active NPI
Kelley Ryals
- Mental Health Counselor
- Pensacola, FL
National Provider Identifier
1245855394
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- Practice address
- 6704 Plantation Rd Unit C
Pensacola, FL 32504-4207 - Phone
- (850) 291-4249
- NPI assigned
- Jun 15, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | MH17803 | FL | |
| Mental Health Counselor | 101YM0800X | Primary |
Addresses
Primary practice location
6704 Plantation Rd Unit C
Pensacola, FL 32504-4207
Mailing address
6704 Plantation Rd Unit C
Pensacola, FL 32504-4207
Phone (850) 291-4249
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MH17803 | Other | FL | DEPT OF HEALTH LICENSURE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | 850-888-3614 | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH17803 | FL | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629763200000",
"number": "1245855394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6704 PLANTATION RD UNIT C",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325044207",
"telephone_number": "850-291-4249"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6704 PLANTATION RD UNIT C",
"city": "PENSACOLA",
"state": "FL",
"postal_code": "325044207",
"telephone_number": "850-291-4249"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RYALS",
"first_name": "KELLEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-15",
"last_updated": "2021-08-24",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "FL",
"license": "MH17803",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DEPT OF HEALTH LICENSURE",
"identifier": "MH17803",
"state": "FL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "850-888-3614",
"affiliation": "N",
"endpointDescription": "Fax machine",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "6704 Plantation Rd Unit C",
"city": "Pensacola",
"state": "FL",
"country_code": "US",
"postal_code": "325044207",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.