Kelly L Carlson, LMHC, M.ED

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH8729 Issued in FL

Practice address

5500 Military TRL
#22-106
Jupiter, FL 33458-2869

Phone

(561) 354-8795

Fax

(561) 743-7165

NPI assigned

Jan 30, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kelly Carlson, LLC Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

Practice roles

Networks

• Freedom Health HMO Network

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.

• Kelly Carlson, LLC

  • Community/Behavioral Health Agency
  • Jupiter, FL
  • NPI 1124468764
  NPD (past) Authorized official
• Kelly Carlson, LLC

  • Mental Health Counselor
  • Stuart, FL
  • NPI 1609277656
  NPD (past) Authorized official

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

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371081600000",
    "number": "1720326408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MILITARY TRL",
            "address_2": "#22-106",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582869",
            "telephone_number": "561-354-8795",
            "fax_number": "561-743-7165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MILITARY TRL",
            "address_2": "#22-106",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334582869",
            "telephone_number": "561-354-8795",
            "fax_number": "561-743-7165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARLSON",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "LMHC, M.ED",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH8729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELLY",
            "last_name": "CARLSON, LLC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Courtney Carlson, LMHC
• Carlstrom Family Chiropractic Center PA
• Christian B. Carlstrom, D.C.
• Denise C. Carlstrom, D.C.
• Jenna Carlyle
• Carnival Meals and Foods, LLC

• Mental Health Counselor in Jupiter, FL
• Providers in Jupiter, 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 Jun 13, 2013; 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.