Brittany J Kelly, MA, CDCA, LPCC, LCDC | |
35895 Royalton Rd, Grafton, OH 44044-9587 | |
(440) 529-9419 | |
(440) 588-8764 |
Full Name | Brittany J Kelly |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 35895 Royalton Rd, Grafton, Ohio |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831253095 | NPI | - | NPPES |
0202505 | Medicaid | OH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | E0008042 (Ohio) | Primary |
101YA0400X | Counselor - Addiction (substance Use Disorder) | 101043 (Ohio) | Secondary |
Entity Name | Mindfully Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1972702520 PECOS PAC ID: 3476606252 Enrollment ID: O20090727000253 |
Mailing Address | Practice Location Address |
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Brittany J Kelly, MA, CDCA, LPCC, LCDC Po Box 1075, Columbia Station, OH 44028-1075 Ph: (440) 529-9419 | Brittany J Kelly, MA, CDCA, LPCC, LCDC 35895 Royalton Rd, Grafton, OH 44044-9587 Ph: (440) 529-9419 |
Claudia Boryka, LPCC Counselor Medicare: Medicare Enrolled Practice Location: 35895 Royalton Rd, Grafton, OH 44044 Phone: 440-529-9419 Fax: 440-588-8764 | |
Kyle Metzger, Counselor Medicare: Not Enrolled in Medicare Practice Location: 11600 Durkee Rd, Grafton, OH 44044 Phone: 216-361-7760 Fax: 216-361-3600 | |
Mr. Jeffrey J Jerabek, LICDC-CS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2500 Avon Belden Rd, Grafton, OH 44044 Phone: 440-748-5747 | |
Marlene Ann Bielek, Counselor Medicare: Not Enrolled in Medicare Practice Location: 35895 Royalton Rd, Grafton, OH 44044 Phone: 440-529-9419 | |
Jennifer Whitten, LPCC-SUPV Counselor Medicare: Medicare Enrolled Practice Location: 2500 Avon Belden Rd, Grafton, OH 44044 Phone: 440-748-5474 | |
Donald Christian, Counselor Medicare: Not Enrolled in Medicare Practice Location: 2075 Avon Belden Rd, Grafton, OH 44044 Phone: 440-748-1049 | |
Kimbrley D Clark, LICDC-CS Counselor Medicare: Not Enrolled in Medicare Practice Location: 2057 S. Avon-belden Rd, Grafton, OH 44044 Phone: 440-748-1049 |