Individual provider Active NPI

Kelly Ann Phelps, LCMHCS

  • Mental Health Counselor
  • Durham, NC
National Provider Identifier
1356678130
Registry record updated Aug 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
S7586 Issued in NC
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

Updated by the provider on Aug 1, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
6104536MedicaidNC
168CYOtherNCBCBS

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250428000094 NC Practitioner - Mental Health Counselor 7012433675 Reassigns benefits to 1 organization

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
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

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

LicenseStateTypeSpecialty
S7586NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Apr 20, 2025 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

Verify at the official NPI Registry.