Kelli Amber Marengo, MNSC, APRN, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

216713 Issued in AR

Practice address

8 S Broadview St Ste Eandf
Greenbrier, AR 72058-9601

Phone

(501) 679-0232

NPI assigned

Jul 8, 2021

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

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Heal Within Counseling and Consulting Inc

  • Community/Behavioral Health Agency
  • Greenbrier, AR
  • NPI 1982290763

  AR, Psychiatric/Mental Health

  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Internal Medicine Physician
  • Little Rock, AR
  • NPI 1588654016

  AR

  Medicare reassignment NPD
• University of Arkansas for Medical Sciences

  • Psychiatry Physician
  • Little Rock, AR
  • NPI 1932261013
  NPD

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

{
    "created_epoch": "1625702400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1821669979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST # 560",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-364-1830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 S BROADVIEW ST STE EANDF",
            "city": "GREENBRIER",
            "state": "AR",
            "postal_code": "720589601",
            "telephone_number": "501-679-0232"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2220 Washington Ave",
            "address_purpose": "LOCATION",
            "city": "Conway",
            "state": "AR",
            "postal_code": "720322762",
            "country_code": "US",
            "telephone_number": "501-679-0232",
            "fax_number": "833-373-0348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3001 W Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Little Rock",
            "state": "AR",
            "postal_code": "722045658",
            "country_code": "US",
            "telephone_number": "501-340-6646",
            "fax_number": "501-975-4129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARENGO",
        "first_name": "KELLI",
        "middle_name": "AMBER",
        "name_prefix": "Ms.",
        "credential": "MNSC, APRN, PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-08",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AR",
            "license": "216713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Michelle Lewter, M.S. CCC-SLP
• Scott Love, M.S. OTR/L
• Amanda V Lovette, PHARM D
• Devon Lowder
• Magnolia Way Counseling and Assessments, LLC
• Holly Martin
• Danielle Matthews
• Elizabeth McClelland, MS, OTR/L
• Alisha Nicole Gray McCool, MNSC, APRN, PMHNP-BC
• Ellen C McCrary

• All providers in Greenbrier, AR
• Psychiatric/Mental Health Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.