Active NPI
Kelly Ann Phelps, LCMHCS
- Mental Health Counselor
- Durham, NC
National Provider Identifier
1356678130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- S7586
- Practice address
- 110 N Corcoran St
Durham, NC 27701-5015 - Phone
- (323) 205-7088
- Fax
- (833) 419-0181
- NPI assigned
- Nov 16, 2009
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 12329 | SC | |
| Mental Health Counselor | 101YM0800X | S7586 | NC | Primary |
Addresses
Primary practice location
110 N Corcoran St
Durham, NC 27701-5015
Mailing address
1650 Lower Stecoah Rd
Robbinsville, NC 28771-9209
Phone (828) 545-3945
Other practice location 1
170 Meeting St Ste 110
Charleston, SC 29401-3178
Phone (323) 205-7088
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6104536 | Medicaid | NC | |
| 168CY | Other | NC | BCBS |
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
110 N Corcoran St
Durham, NC 27701-5015
Phone (323) 205-7088
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S7586 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mental Health Specialty Group PA | Mental Health | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1258329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1785542400000",
"number": "1356678130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 LOWER STECOAH RD",
"city": "ROBBINSVILLE",
"state": "NC",
"postal_code": "287719209",
"telephone_number": "828-545-3945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 N CORCORAN ST",
"city": "DURHAM",
"state": "NC",
"postal_code": "277015015",
"telephone_number": "323-205-7088",
"fax_number": "833-419-0181"
}
],
"practiceLocations": [
{
"address_1": "170 Meeting St Ste 110",
"address_purpose": "LOCATION",
"city": "Charleston",
"state": "SC",
"postal_code": "294013178",
"country_code": "US",
"telephone_number": "323-205-7088",
"fax_number": "833-419-0181",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PHELPS",
"first_name": "KELLY",
"middle_name": "ANN",
"credential": "LCMHCS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-11-16",
"last_updated": "2026-08-01",
"certification_date": "2026-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "SC",
"license": "12329",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NC",
"license": "S7586",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6104536",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "168CY",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Durham, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2026; 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.