Individual provider Active NPI

Carly Melissa Kitko, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Clearfield, PA
National Provider Identifier
1861360927
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
SP034322 Issued in PA
Practice address
216 N 2ND St Ste 5
Clearfield, PA 16830-2547
Phone
(814) 205-4025
NPI assigned
Oct 29, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X SP034322 PA Primary

Addresses

Primary practice location

216 N 2ND St Ste 5
Clearfield, PA 16830-2547

Mailing address

216 N 2ND St Ste 5
Clearfield, PA 16830-2547
Phone (814) 205-4025

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20251215002895 PA Practitioner - Nurse Practitioner 3971097163 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Still Waters Mental Health Services LLCGroup PAC ID 4284052143, 3 clinicians

Practice addresses (Care Compare)

216 N 2ND St
Suite 5
Clearfield, PA 16830-2547
Phone (814) 205-4025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP034322PAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Still Waters Mental Health Services, LLC Psychiatric/Mental Health CurrentSince Nov 4, 2025 Accepting new patients

Locations

216 N 2nd St
Ste 5
Clearfield, PA 16830
Phone (814) 205-4025

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1761696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1861360927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 N 2ND ST STE 5",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168302547",
            "telephone_number": "814-205-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 N 2ND ST STE 5",
            "city": "CLEARFIELD",
            "state": "PA",
            "postal_code": "168302547",
            "telephone_number": "814-205-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KITKO",
        "first_name": "CARLY",
        "middle_name": "MELISSA",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-10-29",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "PA",
            "license": "SP034322",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearfield, PA

Sources for this page

Verify at the official NPI Registry.