Organization Active NPI

Family Mental Health Wellness LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Hillsboro, MO
National Provider Identifier
1598657132
Registry record updated Sep 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
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

Updated by the provider on Sep 30, 2025

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

Authorized official

Name
Danielle KennedyNPI 1063118404
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)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 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 Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250818003950 MO Part B Supplier - Clinic/Group Practice 8820597750 Receives reassigned benefits from 1 practitioner
Practice locations: Hillsboro, MO

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
26D2335629Family Mental Health Wellness LLC424 Main St, Hillsboro, MO 63050Certificate of waiverDec 14, 2027

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.