Kelly C David, LMHC

Primary specialty

PsychologistTaxonomy code 103T00000X

License

MH0003650 Issued in FL

Practice address

7108 Quail Hollow Dr
Panama City Beach, FL 32408-4984

Phone

(850) 740-8082

Fax

(850) 303-0994

NPI assigned

Dec 14, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Mental Health Counselor

Education

Other, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• David, Kelly

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Panama City Beach, FL
  • NPI 1144842527
  Medicare reassignment NPD Authorized official
• J L L MD Inc

  • Psychiatry Physician
  • Panama City Beach, FL
  • NPI 1356416374
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1851376644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27718",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324117718",
            "telephone_number": "850-913-8313",
            "fax_number": "850-249-7424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7108 QUAIL HOLLOW DR",
            "city": "PANAMA CITY BEACH",
            "state": "FL",
            "postal_code": "324084984",
            "telephone_number": "850-740-8082",
            "fax_number": "850-303-0994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVID",
        "first_name": "KELLY",
        "middle_name": "C",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-14",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "MH0003650",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26786",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "593463899",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth Crowell
• Caroline Grace Culley, PHARMD
• Michael Dalton Cutchins, DC
• Adrienne Lee Daisernia, P.T.
• David, Kelly
• Christina Celeste Davis, PA-C
• Faith Elizabeth Davis, M.A.
• DCDW Medical Services Inc (Gulf View Medical)
• Brady Michael Degrasse, LCSW
• Brenda Lea Dement

• Psychologist in Panama City Beach, FL
• Providers in Panama City Beach, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.