Individual provider Active NPI

Kelly Nicole Clemente, LPCC

  • Professional Counselor
  • Alexandria, VA
National Provider Identifier
1568158764
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701014745 Issued in VA
Practice address
3014 Colvin St Ste 1-a
Alexandria, VA 22314-5031
Phone
(703) 936-6214
NPI assigned
Apr 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701014745 VA Primary

Addresses

Primary practice location

3014 Colvin St Ste 1-a
Alexandria, VA 22314-5031

Mailing address

6233 Kellogg Dr
MC Lean, VA 22101-3124
Phone (571) 332-2167

Other practice location 1

6233 Kellogg Dr
Mc Lean, VA 22101-3124
Phone (571) 332-2167

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
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
I20250627002567 VA Practitioner - Mental Health Counselor 9739692302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

1901 E Franklin St
Suite 108
Richmond, VA 23223-6966
Phone (855) 284-7483

5310 Markel Rd
Suite 102
Richmond, VA 23230-3030
Phone (855) 284-7483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Apr 13, 2025 Accepting new patients

Locations

3014 Colvin St
Ste 1A
Alexandria, VA 22314
Phone (703) 828-9054

5310 Markel Rd
Ste 102
Richmond, VA 23230
Phone (804) 312-5498

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745798400000",
    "number": "1568158764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6233 KELLOGG DR",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221013124",
            "telephone_number": "571-332-2167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3014 COLVIN ST STE 1-A",
            "city": "ALEXANDRIA",
            "state": "VA",
            "postal_code": "223145031",
            "telephone_number": "703-936-6214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6233 Kellogg Dr",
            "address_purpose": "LOCATION",
            "city": "Mc Lean",
            "state": "VA",
            "postal_code": "221013124",
            "country_code": "US",
            "telephone_number": "571-332-2167",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "KELLY",
        "middle_name": "NICOLE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-12",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701014745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, VA

Sources for this page

Verify at the official NPI Registry.