Active NPI
Kelley F Mizic, LPC
- Professional Counselor
- Weaver, AL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 2324
- Practice address
- 710 Wana Ave
Weaver, AL 36277-3440 - Phone
- (256) 282-6841
- NPI assigned
- Jul 25, 2007
- Last updated
- Apr 9, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2324 | AL | Primary |
Addresses
Primary practice location
710 Wana Ave
Weaver, AL 36277-3440
Mailing address
508 Goodwin Ave
Anniston, AL 36207
Phone (256) 689-9968
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1996
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
508 Goodwin Ave
Anniston, AL 36207-5716
600 Sun Temple Dr
Madison, AL 35758-8643
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Integrated Behavioral Health, Inc. | Professional | Current | Accepting new patients |
Locations
731 Leighton Ave
Ste 401
Anniston, AL 36207
Phone (256) 435-2229
600 Sun Temple Dr
Madison, AL 35758
Phone (256) 325-2627
25850 Main St
Ardmore, TN 38449
Phone (931) 427-4050
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1185321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1744156800000",
"number": "1649460890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "508 GOODWIN AVE",
"city": "ANNISTON",
"state": "AL",
"postal_code": "36207",
"telephone_number": "256-689-9968"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "710 WANA AVE",
"city": "WEAVER",
"state": "AL",
"postal_code": "362773440",
"telephone_number": "256-282-6841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIZIC",
"first_name": "KELLEY",
"middle_name": "F",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-25",
"last_updated": "2025-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AL",
"license": "2324",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Weaver, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2025; 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.