NPIMap

Organization Active NPI

Kelly Carlson, LLC

  • Mental Health Counselor
  • Stuart, FL
National Provider Identifier
1609277656
Registry record updated Sep 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH8729 Issued in FL
Legal business name
KELLY CARLSON, LLC
Practice address
2026 SE Ocean Blvd
Stuart, FL 34996-3304
Phone
(561) 354-8795
NPI assigned
Sep 9, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2014

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

Authorized official

Name
Kelly Carlson, LMHCNPI 1720326408
Title
Owner
Phone
(561) 354-8795

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
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X MH8729 FL Primary

Addresses

Primary practice location

2026 SE Ocean Blvd
Stuart, FL 34996-3304

Mailing address

5500 Military Trail
#22-106
Jupiter, FL 33458

National Provider Directory

National Provider Directory
Tax ID family
Kelly Carlson LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5500 Military Trl
#22106
Jupiter, FL 33458
Phone (561) 354-8795

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": "1410220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410220800000",
    "number": "1609277656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MILITARY TRAIL",
            "address_2": "#22-106",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "33458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 SE OCEAN BLVD",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349963304",
            "telephone_number": "561-354-8795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY CARLSON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-09",
        "last_updated": "2014-09-09",
        "status": "A",
        "authorized_official_last_name": "CARLSON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-354-8795",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stuart, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; 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.