Individual provider Active NPI

Kelly McDearman, LMHC

  • Mental Health Counselor
  • Apopka, FL
National Provider Identifier
1598101636
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1461 S Lake Pleasant Rd
Apopka, FL 32703-7601
Phone
(407) 886-5405
NPI assigned
May 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 14352 FL
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

1461 S Lake Pleasant Rd
Apopka, FL 32703-7601

Mailing address

1461 S Lake Pleasant Rd
Apopka, FL 32703-7601
Phone (407) 886-5405

Other practice location 1

1800 Mercy Dr
Suite 302
Orlando, FL 32808-5646
Phone (407) 875-3700

Other identifiers 1

IdentifierTypeStateIssuer
1598101636MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
14352FLMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Amikids Behavioral Health, Inc. PastSince May 1, 2021 Accepting new patients
Aspire Health Partners, Inc. Past Accepting new patients

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": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546387200000",
    "number": "1598101636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1461 S LAKE PLEASANT RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327037601",
            "telephone_number": "407-886-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1461 S LAKE PLEASANT RD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327037601",
            "telephone_number": "407-886-5405"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1800 Mercy Dr",
            "address_2": "Suite 302",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328085646",
            "country_code": "US",
            "telephone_number": "407-875-3700",
            "fax_number": "407-522-4671",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDEARMAN",
        "first_name": "KELLY",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-16",
        "last_updated": "2019-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "14352",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598101636",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.