Javonnia Muldrow Kelly, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6529 Issued in SC

Practice address

360 N Irby St
Florence, SC 29501-2808

Phone

(843) 667-9414

Fax

(843) 355-5616

NPI assigned

Dec 10, 2015

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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

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.

• Hopehealth Inc

  • Federally Qualified Health Center (FQHC)
  • Florence, SC
  • NPI 1821002411
  Medicare reassignment NPD
• Embracing Changes Counseling

  • Professional Counselor
  • Florence, SC
  • NPI 1508600073
  NPD Authorized official
• Hopehealth Inc

  • Federally Qualified Health Center (FQHC)
  • Lake City, SC
  • NPI 1649069618
  NPD
• Hopehealth, Inc.

  • Federally Qualified Health Center (FQHC)
  • Florence, SC
  • NPI 1801271903
  NPD
• Hopehealth, Inc

  • Community/Retail Pharmacy
  • Orangeburg, SC
  • NPI 1346601812
  NPD (past)
• Hopehealth, Inc

  • Federally Qualified Health Center (FQHC)
  • Kingstree, SC
  • NPI 1568704583
  NPD (past)
• South Carolina Dept of Mental Health Accounting Office

  • Community/Behavioral Health Agency
  • Columbia, SC
  • NPI 1083421994
  NPD (past)

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

{
    "created_epoch": "1449705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1861867236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414",
            "fax_number": "843-667-1362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 N IRBY ST",
            "city": "FLORENCE",
            "state": "SC",
            "postal_code": "295012808",
            "telephone_number": "843-667-9414",
            "fax_number": "843-355-5616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "JAVONNIA",
        "middle_name": "MULDROW",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-10",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "6529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101YM0800X",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Umeka Keitt
• Hallsy Marie Kellar, LPC
• Justin Kelley, D.O.
• Rebecca Campbell-Smith Kelley, D.O.
• Anna C Kelly, MD
• Laura Lane Kelly, PT
• Dawn L. Kent, CRNA
• Tambra Etoile Ketter
• Laiba Khan, MD
• Emad Khosh Hemmat, MD/MS

• Professional Counselor in Florence, SC
• Providers in Florence, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2024; 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.