Active NPI
Family Mental Health Wellness LLC
- Psychiatric/Mental Health Nurse Practitioner
- Hillsboro, MO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- Legal business name
- FAMILY MENTAL HEALTH WELLNESS LLC
- Doing business as
- FAMILY PSYCHIATRIC AND ADDICTION CARE
- Practice address
- 424 Main St
Hillsboro, MO 63050-4350 - Phone
- (636) 208-5484
- Fax
- (800) 246-0622
- NPI assigned
- Jul 17, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Danielle Kennedy
- Title
- Owner
- Phone
- (636) 208-5486
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | Primary |
Addresses
Primary practice location
424 Main St
Hillsboro, MO 63050-4350
Mailing address
424 Main St
Hillsboro, MO 63050-4350
Phone (636) 208-5486
Other names 1
- FAMILY PSYCHIATRIC AND ADDICTION CARE
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 26D2335629 | Family Mental Health Wellness LLC | Certificate of waiver | Dec 14, 2027 |
National Provider Directory
National Provider DirectoryLocations
424 Main St
Hillsboro, MO 63050
Phone (636) 208-5484
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Hillsboro, MO
- NPI 1063118404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752710400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1759190400000",
"number": "1598657132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "424 MAIN ST",
"city": "HILLSBORO",
"state": "MO",
"postal_code": "630504350",
"telephone_number": "636-208-5486",
"fax_number": "800-246-0622"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "424 MAIN ST",
"city": "HILLSBORO",
"state": "MO",
"postal_code": "630504350",
"telephone_number": "636-208-5484",
"fax_number": "800-246-0622"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY MENTAL HEALTH WELLNESS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-07-17",
"last_updated": "2025-09-30",
"certification_date": "2025-09-30",
"status": "A",
"authorized_official_last_name": "KENNEDY",
"authorized_official_first_name": "DANIELLE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "636-208-5486"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "FAMILY PSYCHIATRIC AND ADDICTION CARE",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Hillsboro, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.