Individual provider Active NPI

Kelly Jo Kaye, LMHC

  • Mental Health Counselor
  • Melbourne, FL
National Provider Identifier
1689740524
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH5001 Issued in FL
Practice address
6767 N Wickham Rd
Suite 306
Melbourne, FL 32940-2031
Phone
(321) 751-1925
Fax
(321) 751-9261
NPI assigned
Nov 24, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH5001 FL Primary

Addresses

Primary practice location

6767 N Wickham Rd
Suite 306
Melbourne, FL 32940-2031

Mailing address

6767 N Wickham Rd
Suite 306
Melbourne, FL 32940-2031
Phone (321) 751-1925

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20231109003546 FL Practitioner - Mental Health Counselor 2264889401 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psychology Associates of Brevard PLCGroup PAC ID 9638078025, 7 clinicians

Practice addresses (Care Compare)

6767 N Wickham Rd
Suite 306
Melbourne, FL 32940-2025
Phone (321) 751-1925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH5001FLMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychology Associates of Brevard PLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

6767 N Wickham Rd
Ste 306
Melbourne, FL 32940
Phone (321) 751-1925

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217980800000",
    "number": "1689740524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6767 N WICKHAM RD",
            "address_2": "SUITE 306",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402031",
            "telephone_number": "321-751-1925",
            "fax_number": "321-751-9261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6767 N WICKHAM RD",
            "address_2": "SUITE 306",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329402031",
            "telephone_number": "321-751-1925",
            "fax_number": "321-751-9261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAYE",
        "first_name": "KELLY JO",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-24",
        "last_updated": "2008-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH5001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

Verify at the official NPI Registry.