KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC) – Professional Counselor, NPI 1003362476

KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC) is a healthcare provider. based in Jacksonville, Florida. specializing in Professional Counselor. They hold the professional credentials MA, NCC, BC-TMH, LPC. They hold a License No. 2015002771 (MO). The NPI Number for KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC) is 1003362476

Main info

Female
Name
KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC)
NPI
1003362476
Phone
(314) 541-6256
Address
9518 OHIO ST
Enumeration Date
26 August 2016
Last Update Date
14 October 2025
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness85
Years active:9State licenses:4Digital endpointsOther names

Provider Addresses for KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC)

  • 9518 OHIO ST

    JACKSONVILLE, FL 322186058

    Phone: (314) 541-6256

    Type: Mailing

  • 6327 COVENTRY DR

    FLORISSANT, MO 630337914

    Phone: (904) 750-1229

    Type: Mailing

  • 2323 S TROY ST STE 3-107

    AURORA, CO 800141982

    Phone: (314) 541-6256

    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: 2024-04-15

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
I20240415002851IMental Health CounselorCOTBD

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 32218)

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Reviews

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Frequently asked questions

How is KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC) identified in CMS data?
CMS-hosted NPPES data lists KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC) with NPI 1003362476.
Does CMS list KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC) as active?
Yes — KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC) is active in the NPI listing used on this page.
What taxonomy line describes KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC)?
For research purposes, treat KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC) as Professional Counselor in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC)?
KELLIE VAZQUEZ (MA, NCC, BC-TMH, LPC)'s geographic hint is Jacksonville, Florida in our summary view.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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