Kenneth Speights, MASTER DEGREE IN PSY

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH18184 Issued in FL

Practice address

20311 Central Ave W
Blountstown, FL 32424-1947

Phone

(850) 674-8888

Fax

(850) 237-1223

NPI assigned

Nov 17, 2015

Sex

Male

Sole proprietor

Yes

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 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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Panhandle Therapy Center LLC 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.

• Panhandle Therapy Center LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Blountstown, FL
  • NPI 1457981888

  FL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1447718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712880000000",
    "number": "1871967786",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16331 SE PEACH ST",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324242211",
            "telephone_number": "850-237-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20311 CENTRAL AVE W",
            "city": "BLOUNTSTOWN",
            "state": "FL",
            "postal_code": "324241947",
            "telephone_number": "850-674-8888",
            "fax_number": "850-237-1223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPEIGHTS",
        "first_name": "KENNETH",
        "credential": "MASTER DEGREE IN PSY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-17",
        "last_updated": "2024-04-12",
        "certification_date": "2024-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH18184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gerald Wayne Skipper Jr., M.D.
• Rita Smith, ARNP
• Sally Lee Smith, BCBA
• Marshell Solomon, LPN
• Sonder Wellness LLC
• Amber Sylese Stevens
• Tallahassee Memorial Healthcare Inc
• Tallahassee Memorial Healthcare Inc
• Tender Loving Enrichment Services
• Allison Nichole Tipton, PMHNP

• All providers in Blountstown, FL
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.