Kelli Lee Mistry, MA LLPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6451019064 Issued in MI

Practice address

204 S Macomb St Ste 7
Monroe, MI 48161-2121

Phone

(734) 265-6749

NPI assigned

Feb 15, 2021

Last updated

Feb 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1613347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644278400000",
    "number": "1376136986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 LAVENDER ST",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481622818",
            "telephone_number": "734-261-6749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 S MACOMB ST STE 7",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481612121",
            "telephone_number": "734-265-6749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MISTRY",
        "first_name": "KELLI",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "MA LLPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-15",
        "last_updated": "2022-02-08",
        "certification_date": "2022-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401019064",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6451019064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shawn Milner, NP
• Mindful Operations LLC (Humanistic Wellness Center)
• Mini Mitten Pediatric Therapy, LLC
• Bridgette Minney
• Miro-Monroe (American Oncologic Associates of Michigan, PC)
• Erin Mitchell
• Mary Mitroka
• Mohamed Soofi, MD PC
• Manzur Moidunny, MD
• Julia Ann Mominee, RN BSN

• Mental Health Counselor in Monroe, MI
• Providers in Monroe, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2022; 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.