Individual provider Active NPI

Kelsey Marie Demart, LPCC

  • Mental Health Counselor
  • Boardman, OH
National Provider Identifier
1932725041
Registry record updated Jun 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
E.2303593 Issued in OH
Practice address
725 Boardman Canfield Rd
Boardman, OH 44512-4380
Phone
(330) 797-4050
NPI assigned
Jun 24, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C.2103441 OH
Mental Health Counselor 101YM0800X E.2303593 OH Primary

Addresses

Primary practice location

725 Boardman Canfield Rd
Boardman, OH 44512-4380

Mailing address

144 Robin Hood Dr
Youngstown, OH 44511-3638
Phone (330) 502-0712

Other identifiers 1

IdentifierTypeStateIssuer
1932725041MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, NY, TX, MA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20231121002456 OH Practitioner - Mental Health Counselor 2567810138 Reassigns benefits to 3 organizations
I20260609002194 NY Practitioner - Mental Health Counselor 2567810138 Reassigns benefits to 1 organization
I20260610004757 TX Practitioner - Mental Health Counselor 2567810138 Reassigns benefits to 1 organization
I20260614000138 MA Practitioner - Mental Health Counselor 2567810138 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renewing Hope LLCGroup PAC ID 2264883685, 2 clinicians

Practice addresses (Care Compare)

144 Robin Hood Dr
Youngstown, OH 44511-3638
Phone (330) 502-0712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C.2103441OHMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Rajendra P Koirala, M.D., LLC CurrentSince Jan 1, 2024 Accepting new patients
Renewing Hope LLC Mental Health CurrentSince Nov 18, 2023 Accepting new patients

Locations

725 Boardman Canfield Rd
Ste L1
Youngstown, OH 44512
Phone (330) 330-8655

725 Boardman Canfield Rd
Ste M
Youngstown, OH 44512
Phone (330) 330-8655

Organizations & group practices 4

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": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686873600000",
    "number": "1932725041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "144 ROBIN HOOD DR",
            "city": "YOUNGSTOWN",
            "state": "OH",
            "postal_code": "445113638",
            "telephone_number": "330-502-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 BOARDMAN CANFIELD RD",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445124380",
            "telephone_number": "330-797-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMART",
        "first_name": "KELSEY",
        "middle_name": "MARIE",
        "credential": "LPCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2023-06-16",
        "certification_date": "2023-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "C.2103441",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E.2303593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1932725041",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boardman, OH

Sources for this page

Verify at the official NPI Registry.