Individual provider Active NPI

Christine Natasha Williams Kelly, MA

  • Mental Health Counselor
  • Melbourne, FL
National Provider Identifier
1376821637
Registry record updated Mar 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH16677 Issued in FL
Practice address
1900 S Harbor City Blvd Ste 103
Melbourne, FL 32901-4725
Phone
(321) 271-8213
Fax
(321) 726-0404
NPI assigned
Aug 3, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH16677 FL Primary

Addresses

Primary practice location

1900 S Harbor City Blvd Ste 103
Melbourne, FL 32901-4725

Mailing address

155 Faulkner St SW
Palm Bay, FL 32908-4825
Phone (321) 271-8213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20250530003248 FL Practitioner - Mental Health Counselor 8224547302 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
All in Mental Health CurrentSince Mar 16, 2025 Accepting new patients
Circles of Care, Inc. Mental Health PastSince Mar 6, 2022 Accepting new patients

Locations

1900 S Harbor City Blvd
Ste 103
Melbourne, FL 32901
Phone (321) 271-8213

5240 Babcock St NE
Ste 300A
Palm Bay, FL 32905
Phone (321) 914-0113

Organizations & group practices 2

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": "1312329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741996800000",
    "number": "1376821637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 FAULKNER ST SW",
            "city": "PALM BAY",
            "state": "FL",
            "postal_code": "329084825",
            "telephone_number": "321-271-8213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S HARBOR CITY BLVD STE 103",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329014725",
            "telephone_number": "321-271-8213",
            "fax_number": "321-726-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS KELLY",
        "first_name": "CHRISTINE",
        "middle_name": "NATASHA",
        "name_prefix": "Mrs.",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-03",
        "last_updated": "2025-03-15",
        "certification_date": "2025-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH16677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.