Individual provider Active NPI

Mariya Kelly

  • Professional Counselor
  • Franklin Lakes, NJ
National Provider Identifier
1639775513
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
37PC00722000 Issued in NJ
Practice address
851 Franklin Lake Rd Ste 204
Franklin Lakes, NJ 07417-2267
Phone
(833) 937-2724
NPI assigned
Dec 7, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 37PC00722000 NJ Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 37LC00323700 NJ

Addresses

Primary practice location

851 Franklin Lake Rd Ste 204
Franklin Lakes, NJ 07417-2267

Mailing address

851 Franklin Lake Rd Ste 204
Franklin Lakes, NJ 07417-2267

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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 1

Enrollment IDStateProvider typePAC IDDetails
I20260219000412 NJ Practitioner - Mental Health Counselor 5294215000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10 -15 Fair Lawn Ave
Fair Lawn, NJ 07410-1822

331 Newman Spring Rd
BLDG 3 Suite 320
Red Bank, NJ 07701-5666

851 Franklin Lake Rd
Suite 204
Franklin Lakes, NJ 07417-2267

908 Pompton Ave
Suite B2
Cedar Grove, NJ 07009-1290

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37LC00323700NJMDAddiction (Substance Use Disorder) Counselor
37PC00722000NJMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Baker Street Behavioral Health CurrentSince Jan 20, 2026 Accepting new patients
Youth & Family Counseling Service Inc CurrentSince Dec 13, 2020 Accepting new patients
Youth & Family Counseling Service Inc PastSince Dec 13, 2020 Accepting new patients

Locations

15-01 Broadway
Ste 30A
Fair Lawn, NJ 07410
Phone (201) 381-6136

851 Franklin Lake Rd
Ste 204
Franklin Lakes, NJ 07417
Phone (201) 381-6136

233 Prospect St
Westfield, NJ 07090
Phone (908) 233-2042

Organizations & group practices 3

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": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1639775513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "851 FRANKLIN LAKE RD STE 204",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074172267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "851 FRANKLIN LAKE RD STE 204",
            "city": "FRANKLIN LAKES",
            "state": "NJ",
            "postal_code": "074172267",
            "telephone_number": "833-937-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "MARIYA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00722000",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00323700",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Franklin Lakes, NJ

Sources for this page

Verify at the official NPI Registry.