Tracy Lee Kelso, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11185 Issued in FL

Practice address

3346 49TH Street North
Suite 108
St. Petersburg, FL 33710-1543

Phone

(727) 743-9337

NPI assigned

Apr 4, 2012

Sex

Female

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

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.

• Brave Health Inc.

  • Community/Behavioral Health Agency
  • Miami, FL
  • NPI 1821588674
  NPD

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

{
    "created_epoch": "1333497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581552000000",
    "number": "1982960837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3346 49TH STREET NORTH",
            "address_2": "SUITE 108",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337101543",
            "telephone_number": "727-743-9337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3346 49TH STREET NORTH",
            "address_2": "SUITE 108",
            "city": "ST. PETERSBURG",
            "state": "FL",
            "postal_code": "337101543",
            "telephone_number": "727-743-9337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1951 NW 7th Ave Ste 300",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331361112",
            "country_code": "US",
            "telephone_number": "305-902-6347",
            "fax_number": "727-306-8033",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KELSO",
        "first_name": "TRACY",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-04",
        "last_updated": "2020-02-13",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carolyn Kelly, ARNP
• Erin Kelly, CRNP
• Jacqueline Nicole Kelly
• Lynea M. Kelly, MD
• Kirsten Kelsey, APRN
• Kathleen Marie Kelzer
• Nadaa Kemmou, MD
• Rebekah Anne Kemp, OD
• Viengchai Kempienski
• Andie Elizabeth Kendall

• Mental Health Counselor in St. Petersburg, FL
• Providers in St. Petersburg, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2020; 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.