Individual provider Active NPI

Emily Kelly

  • Professional Counselor
  • Bristol, CT
National Provider Identifier
1992158604
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
003551 Issued in CT
Practice address
225 N Main St Ste Suite80
Bristol, CT 06010-4926
Phone
(860) 506-7905
NPI assigned
Jul 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 003551 CT Primary
Mental Health Counselor 101YM0800X 068.0136426 VT

Addresses

Primary practice location

225 N Main St Ste Suite80
Bristol, CT 06010-4926

Mailing address

225 N Main St Ste 80
Bristol, CT 06010-4926
Phone (413) 285-3274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20240605002199 CT Practitioner - Mental Health Counselor 7911449996 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Within Reach LLCGroup PAC ID 3678804879, 5 clinicians

Practice addresses (Care Compare)

225 N Main St
Bristol, CT 06010-4926
Phone (203) 510-1002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
068.0136426VTMDMental Health Counselor
003551CTMDProfessional Counselor
3551CTMDClinical Neuropsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Mental Health Specialty Group PA Mental Health CurrentSince Aug 1, 2025 Accepting new patients
Within Reach LLC CurrentSince May 29, 2024 Accepting new patients

Locations

225 N Main St
Bristol, CT 06010
Phone (203) 510-1002

225 N Main St
Ste 80
Bristol, CT 06010
Phone (413) 342-0397

100 Pearl St
Hartford, CT 06103
Phone (860) 969-1463

Organizations & group practices 2

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": "1468800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1992158604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N MAIN ST STE 80",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104926",
            "telephone_number": "413-285-3274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 N MAIN ST STE SUITE80",
            "city": "BRISTOL",
            "state": "CT",
            "postal_code": "060104926",
            "telephone_number": "860-506-7905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "EMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-18",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "003551",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VT",
            "license": "068.0136426",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, CT

Sources for this page

Verify at the official NPI Registry.