KELLY JENNINGS (MH 21536) – Mental Health Counselor, NPI 1043923147

KELLY JENNINGS (MH 21536) is a healthcare provider. based in Lakeland, Florida. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MH 21536. They hold a License No. MH21536 (FL). The NPI Number for KELLY JENNINGS (MH 21536) is 1043923147

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
KELLY JENNINGS (MH 21536)
NPI
1043923147
Phone
(352) 708-6283
Address
100 S Kentucky Ave
Enumeration Date
4 January 2023
Last Update Date
8 July 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3529886673
Graduation Year
2020 (6 years ago)
PAC ID
6800249772
Group Practice PAC ID
0648623835
Professional Enrollment ID
I20240126001513
Address ID
FL327784044TA858XXDRXX400
Telehealth
Yes

Contacts

Secure Messaging
kellyj@familylife.group
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness85
Years active:3State licenses:1Other namesUpdated within 12 months

3,018 MENTAL HEALTH COUNSELOR in FL

Provider Addresses for KELLY JENNINGS (MH 21536)

  • 100 S Kentucky Ave

    Lakeland, FL 338015096

    Phone: (352) 708-6283

    Type: Location

  • 1965 S Orange Blossom Trl

    Apopka, FL 327037757

    Phone: (352) 708-6283

    Type: Location

  • 9100 Conroy Windermere Rd

    Windermere, FL 347868431

    Phone: (352) 708-6283

    Type: Location

  • 858 S Duncan Dr

    Tavares, FL 327784044

    Phone: (352) 708-6283

    Type: Location

  • 210 N Highway 27 Ste 4

    Clermont, FL 347112411

    Phone: (352) 708-6283

    Type: Location

  • 135 TYRINGHAM RD

    EUSTIS, FL 32726

    Phone: (352) 354-4004

    Type: Mailing

  • 858 S DUNCAN DR

    TAVARES, FL 327784044

    Phone: (352) 609-5103

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240126001513IMental Health CounselorFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33801)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0648623835View full group profile
NameSpecialtyState
Mental Health CounselorFL
Mental Health CounselorFL
Mental Health CounselorFL
Mental Health CounselorFL
Marriage And Family TherapistFL
Clinical Social WorkerFL
Clinical Social WorkerFL
Marriage And Family TherapistFL
Mental Health CounselorFL
Mental Health CounselorGA

Reviews

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Frequently asked questions

What number should I use to identify KELLY JENNINGS (MH 21536) for billing?
Administrative and clinical systems typically use NPI 1043923147 for KELLY JENNINGS (MH 21536).
Quick check: is KELLY JENNINGS (MH 21536) active?
Public NPPES data shows KELLY JENNINGS (MH 21536) with an active NPI status right now.
How should patients interpret KELLY JENNINGS (MH 21536)'s specialty?
The extract shows Mental Health Counselor for KELLY JENNINGS (MH 21536). Clinical services aligned with this taxonomy classification.
Can patients visit KELLY JENNINGS (MH 21536) in Lakeland, Florida?
For routing, start with Lakeland, Florida for KELLY JENNINGS (MH 21536), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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