Active NPI
Kelley Knowles
- Marriage & Family Therapist
- New York, NY
National Provider Identifier
1568853596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT4912
- Practice address
- 50 Broadway
11TH Floor
New York, NY 10004 - Phone
- (800) 543-3638
- NPI assigned
- Feb 12, 2015
- Last updated
- May 19, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Marriage & Family Therapist | 106H00000X | MT4912 | FL | Primary |
Addresses
Primary practice location
50 Broadway
11TH Floor
New York, NY 10004
Mailing address
1137 NE 3Rd Avenue
Fort Lauderdale, FL 33304-1607
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Nova Southeastern College of Osteo Medicine, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4601 Sheridan St
Suite 400
Hollywood, FL 33021-3435
Phone (954) 737-3957
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT4912 | FL | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gra Therapy Solutions, LLC | Current | Accepting new patients |
Locations
4601 Sheridan St
Ste 400
Hollywood, FL 33021
Phone (561) 617-3437
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.
-
dba Ellie Mental Health
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Hollywood, FL
- NPI 1184269144
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423699200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747612800000",
"number": "1568853596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1137 NE 3RD AVENUE",
"city": "FORT LAUDERDALE",
"state": "FL",
"postal_code": "333041607"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 BROADWAY",
"address_2": "11TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10004",
"telephone_number": "800-543-3638"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNOWLES",
"first_name": "KELLEY",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-02-12",
"last_updated": "2025-05-19",
"certification_date": "2025-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT4912",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
- Rita Maria Knotts, M.D.
- Knowing Physical Therapy PC
- Knowing Wellness, LLC (Knosis Center for Physiotherapy & Wellness)
- Knowledge Health Medical Services PC
- Daniel Knowles, M.D.
- Kimarie Boerger Knowles, LCSW
- Stephen Knowles, STUDENT, HEALTH CARE
- Ebony Knowlin, LCSW
- Donna C Knowlton, DDS
- Justin A Knox
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2025; 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.