Stephanie Ann Kelly, MA, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH17627 Issued in FL

Practice address

1111 Oakfield Dr
Brandon, FL 33511-4930

Phone

(813) 563-9553

NPI assigned

Feb 4, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT, NH, IN, OH, MI, NM, PA, ID, VT9 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 9

Specialty

Mental Health Counselor

Education

Other, 2009

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: fbh.stephaniekelly@141363.advancedmd-direct.com

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  CT, ID, IN, MI, NH, NM, OH, PA, VT

  Medicare reassignment NPD
• Spccsmdbrandon Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Brandon, FL
  • NPI 1679223531
  NPD
• Peaceful Pastures Therapy LLC

  • Clinical Social Worker
  • Webster, FL
  • NPI 1801483060

  Mental Health

  NPD (past)
• Shine Medical Providers PC

  • Psychiatry Physician
  • Philadelphia, PA
  • NPI 1538894050
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1580774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1619508017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5829 W KNIGHTS GRIFFIN RD",
            "city": "PLANT CITY",
            "state": "FL",
            "postal_code": "335653711",
            "telephone_number": "813-464-4545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 OAKFIELD DR",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335114930",
            "telephone_number": "813-563-9553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "207 W Morgan St",
            "address_purpose": "LOCATION",
            "city": "Brandon",
            "state": "FL",
            "postal_code": "335104429",
            "country_code": "US",
            "telephone_number": "813-244-1251",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36178 Gresham Rd",
            "address_purpose": "LOCATION",
            "city": "Webster",
            "state": "FL",
            "postal_code": "335979287",
            "country_code": "US",
            "telephone_number": "813-449-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "242 S Washington Blvd Ste 127",
            "address_purpose": "LOCATION",
            "city": "Sarasota",
            "state": "FL",
            "postal_code": "342366943",
            "country_code": "US",
            "telephone_number": "941-806-5722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELLY",
        "first_name": "STEPHANIE",
        "middle_name": "ANN",
        "credential": "MA, LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-04",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17627",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Barbara Eileen Kelly
• Dasia Kelly, RBT
• Meghan Kelly, MED, BCBA
• Melissa Kelly, M.S., C.C.C.
• Patricia K Kelly, OTA9207
• Ashley Kemp, SA
• Bobby Wayne Kemp II, PHARM.D.
• Katrina Dawn Kemp, PA-C
• Cheyenne Kendrick
• Margaret Kennard, RNFA

• Mental Health Counselor in Brandon, FL
• Providers in Brandon, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.

Verify at the official NPI Registry.