Individual provider Active NPI

Kelly Jeanne Brotherton, LPC

  • Social Worker
  • Farmington, MO
National Provider Identifier
1740294750
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
1085 Maple St
Farmington, MO 63640-1955
Phone
(573) 756-5353
Fax
(573) 756-4316
NPI assigned
Jul 27, 2006
Last updated
Feb 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 2009023502 MO
Social Worker 104100000X NU Primary

Addresses

Primary practice location

1085 Maple St
Farmington, MO 63640-1955

Mailing address

3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101
Phone (314) 206-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20240227000906 MO Practitioner - Mental Health Counselor 8022453349 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BJC Behavioral HealthGroup PAC ID 1153225271, shared by 2 NPIs, 63 clinicians

Practice addresses (Care Compare)

3309 S Kingshighway Blvd
Saint Louis, MO 63139-1101
Phone (314) 206-3700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
BJC Behavioral Health CurrentSince Apr 16, 2025 Accepting new patients
BJC Behavioral Health CurrentSince Jan 14, 2024 Accepting new patients

Locations

1085 Maple St
Farmington, MO 63640
Phone (573) 756-5353

1430 Olive St
Ste 400
Saint Louis, MO 63103

3309 S Kingshighway Blvd
Saint Louis, MO 63139
Phone (314) 534-9350

Interoperability endpoints

  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Organizations & group practices 2

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": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1740294750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3309 S KINGSHIGHWAY BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631391101",
            "telephone_number": "314-206-3700",
            "fax_number": "573-756-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1085 MAPLE ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401955",
            "telephone_number": "573-756-5353",
            "fax_number": "573-756-4316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROTHERTON",
        "first_name": "KELLY",
        "middle_name": "JEANNE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-27",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MO",
            "license": "2009023502",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington, MO

Sources for this page

Verify at the official NPI Registry.