Crystal Ann Kelly, MS, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MT4455 Issued in FL

Practice address

1111 SE Federal Hwy Ste 334
Stuart, FL 34994-3839

Phone

(239) 690-6906

NPI assigned

Oct 24, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Crystal Ann Kelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Sunflowers Bloom Wellness LLC

  • Marriage & Family Therapist
  • Port St Lucie, FL
  • NPI 1194555664
  NPD Authorized official
• Mental Health Association in Indian River County Inc

  • Community/Behavioral Health Agency
  • Vero Beach, FL
  • NPI 1760570451
  NPD (past)

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

{
    "created_epoch": "1666569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1346967023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3466 SW PLUTO ST",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349533483",
            "telephone_number": "954-465-0993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 SE FEDERAL HWY STE 334",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349943839",
            "telephone_number": "239-690-6906"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3466 SW Pluto St",
            "address_purpose": "LOCATION",
            "city": "Port St Lucie",
            "state": "FL",
            "postal_code": "349533483",
            "country_code": "US",
            "telephone_number": "954-465-0993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "CRYSTAL",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MS, LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-24",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT4455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRYSTAL",
            "last_name": "KELLY",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brian Kelley, D.C.
• Cynda Kelley, LM
• Danielle Alice Kelley, BEHAVIORAL HEALTH
• Kelly Carlson, LLC
• Robert N/a Kelly-Jr-III
• Laurie Kelly
• Michaela Kelly
• Rebecca Ellen Kelly
• Arianna Kelsey
• Klaudia Gabriella Kemenes

• Marriage & Family Therapist in Stuart, FL
• Providers in Stuart, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.