Individual provider Active NPI

Je'Nae Kelley

  • Professional Counselor
  • Houston, TX
National Provider Identifier
1376032516
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
88931 Issued in TX
Practice address
11455 Fallbrook Dr Ste 101
Houston, TX 77065-4266
Phone
(713) 457-4372
NPI assigned
May 3, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Professional Counselor 101YP2500X 88931 TX Primary

Addresses

Primary practice location

11455 Fallbrook Dr Ste 101
Houston, TX 77065-4266

Mailing address

55 Dodge Rd
Getzville, NY 14068-1205
Phone (716) 831-2700

Other practice location 1

3020 Bailey Ave
Buffalo, NY 14215-2814
Phone (716) 831-2700

Medicare participation

Medicare enrollment files
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
88931TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Kinghaven Counseling Group Inc Professional CurrentSince May 10, 2024 Accepting new patients
Horizon Health Services Inc PastSince Sep 1, 2019 Accepting new patients
Shine Medical Providers PC Past Accepting new patients

Locations

11455 Fallbrook Dr
Ste 101
Houston, TX 77065
Phone (281) 897-9966

6315 Gulfton St
Ste 100
Houston, TX 77081
Phone (713) 457-4357

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEGDAA

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1525305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1376032516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 DODGE RD",
            "city": "GETZVILLE",
            "state": "NY",
            "postal_code": "140681205",
            "telephone_number": "716-831-2700",
            "fax_number": "716-831-1818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11455 FALLBROOK DR STE 101",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770654266",
            "telephone_number": "713-457-4372"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3020 Bailey Ave",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142152814",
            "country_code": "US",
            "telephone_number": "716-831-2700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "JE'NAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-03",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "88931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.