Active NPI
Melissa Anna Kelly, LPC, LCDC
- Professional Counselor
- San Antonio, TX
National Provider Identifier
1891542429
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 82950
- Practice address
- 1527 Schley Ave
San Antonio, TX 78210-4352 - Phone
- (210) 326-6825
- NPI assigned
- May 1, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15243 | TX | |
| Professional Counselor | 101YP2500X | 82950 | TX | Primary |
Addresses
Primary practice location
1527 Schley Ave
San Antonio, TX 78210-4352
Mailing address
1527 Schley Ave
San Antonio, TX 78210-4352
Phone (210) 326-6825
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15243 | TX | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714521600000",
"number": "1891542429",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1527 SCHLEY AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782104352",
"telephone_number": "210-326-6825"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1527 SCHLEY AVE",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782104352",
"telephone_number": "210-326-6825"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KELLY",
"first_name": "MELISSA",
"middle_name": "ANNA",
"credential": "LPC, LCDC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-05-01",
"last_updated": "2024-05-01",
"certification_date": "2024-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "TX",
"license": "15243",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "82950",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.