Active NPI
Kelly Dzioba
- Mental Health Counselor
- South Pasadena, FL
National Provider Identifier
1720916489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- IMH28402
- Practice address
- 1615 Pasadena Ave S Ste 330
South Pasadena, FL 33707-4567 - Phone
- (727) 940-9538
- NPI assigned
- May 12, 2026
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | IMH28402 | FL | Primary |
Addresses
Primary practice location
1615 Pasadena Ave S Ste 330
South Pasadena, FL 33707-4567
Mailing address
1615 Pasadena Ave S Ste 330
South Pasadena, FL 33707-4567
Phone (727) 940-9538
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| IMH28402 | FL | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1778544000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778544000000",
"number": "1720916489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1615 PASADENA AVE S STE 330",
"city": "SOUTH PASADENA",
"state": "FL",
"postal_code": "337074567",
"telephone_number": "727-940-9538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1615 PASADENA AVE S STE 330",
"city": "SOUTH PASADENA",
"state": "FL",
"postal_code": "337074567",
"telephone_number": "727-940-9538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DZIOBA",
"first_name": "KELLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-12",
"last_updated": "2026-05-12",
"certification_date": "2026-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "FL",
"license": "IMH28402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Pasadena, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.