Kelsey L. Mazzocco, ATC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

403 Stoney Landing Road
Moncks Corner, SC 29461-3967

Phone

(864) 294-2000

NPI assigned

Jul 25, 2016

Last updated

Aug 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Berkeley Community Mental Health Center

  • Exclusive Provider Organization
  • Moncks Corner, SC
  • NPI 1205065828
  NPD (past)
• South Carolina Dept of Mental Health Accounting Office

  dba Berkeley Community Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Moncks Corner, SC
  • NPI 1508811324
  NPD (past)

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

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1679026868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 STONEY LANDING ROAD",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 STONEY LANDING ROAD",
            "city": "MONCKS CORNER",
            "state": "SC",
            "postal_code": "294613967",
            "telephone_number": "864-294-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZOCCO",
        "first_name": "KELSEY",
        "middle_name": "L.",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "SC",
            "license": "1986",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435201",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Elizabeth Manilenko, M.A., CCC-SLP
• Helene Marchand, NP
• Kanetra M Martin
• Marc Marvin, PHARMD
• Mary Matthews, PT
• Donna M McClure
• Nicholas Aaron McCoy, D.C.
• Christy Y. McCrea, LPN
• Melanie McEndree, LMT,NMT
• Hayden McKenney, PA-C

• Mental Health Counselor in Moncks Corner, SC
• Providers in Moncks Corner, SC by specialty
• Mental Health Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.