Kelly Lane Stevens, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Practice address

13453 N Main St Ste 104
Jacksonville, FL 32218-2773

Phone

(904) 773-4390

Fax

(941) 621-7089

NPI assigned

Jan 17, 2018

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 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

Marriage and Family Therapist

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Discovery Mental Health Services PAGroup PAC ID 7113310939, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Discovery Mental Health Services

  • Mental Health Counselor
  • Jacksonville, FL
  • NPI 1023697745

  Marriage & Family Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• J&K Mental Health Services LLC

  • Marriage & Family Therapist
  • Jacksonville, FL
  • NPI 1245031582
  NPD Authorized official

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

{
    "created_epoch": "1516147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711670400000",
    "number": "1861900458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST",
            "address_2": "SUITE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32218",
            "telephone_number": "904-773-4390",
            "fax_number": "941-621-7089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13453 N MAIN ST STE 104",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322182773",
            "telephone_number": "904-773-4390",
            "fax_number": "941-621-7089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "KELLY",
        "middle_name": "LANE",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-17",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "SG014",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gerald Allen Stevens, ATC, LAT
• Jasmine Stevens
• Kandice Stevens
• Kaphaedra Stevens
• Kathleen Marie Stevens, MSW, LCSW
• Raquel Sade Stevens
• Rebeka Stevens
• Wendy H Stevens, PA-C
• Julie Ann Stevenson Kelly, MSW
• Heather Stevenson

• Marriage & Family Therapist in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Marriage & Family Therapist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 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.
• 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.