Kelly Michelle White, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A16324 Issued in NC

Practice address

4607 Charlotte Hwy Ste 18
Lake Wylie, SC 29710-8149

Phone

(803) 630-3247

NPI assigned

Feb 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Michelle Montross Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kelly@serenitytherapyservices.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Thrive Counseling Services, PLLC

  • Community/Behavioral Health Agency
  • Monroe, NC
  • NPI 1477961506
  Medicare reassignment
• Serenity Therapy Services

  • Mental Health Counselor
  • Lake Wylie, SC
  • NPI 1568060291
  NPD

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

{
    "created_epoch": "1612224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612224000000",
    "number": "1285225193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 OAKMERE RD",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736042",
            "telephone_number": "704-604-7196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4607 CHARLOTTE HWY STE 18",
            "city": "LAKE WYLIE",
            "state": "SC",
            "postal_code": "297108149",
            "telephone_number": "803-630-3247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KELLY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-02",
        "last_updated": "2021-02-02",
        "certification_date": "2021-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A16324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kelly@serenitytherapyservices.net",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "Lake Wylie",
            "address_1": "4607 Charlotte Hwy Ste 18",
            "city": "Lake Wylie",
            "state": "SC",
            "country_code": "US",
            "postal_code": "297108149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "MONTROSS",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walgreen Co (Walgreens #10838)
• Gabrielle Star Walker, PT, DPT
• Matt Walker, DPT
• Well-Balanced at Home Physical Therapy LLC
• Sarah West
• Hannah Wilkerson
• Jill R Winter, PT
• Diane J. Wooldridge, PT
• Dana Michele Wurm, MS, OTR, CLT

• Mental Health Counselor in Lake Wylie, SC
• Providers in Lake Wylie, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 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; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.