KELLY JANESE BALLANTINE LMHC NPI 1649576596

NPI Information

  • NPI: 1649576596
  • Provider Name: KELLY JANESE BALLANTINE, LMHC
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 1835 GILMORE AVE
    LAKELAND, FL
    ZIP 33805
  • Phone: (863) 519-0575

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NPI Details

Kelly Janese Ballantine, LMHC is a mental health counselor in Lakeland, FL. Kelly Janese Ballantine, LMHC NPI is 1649576596. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1835 GILMORE AVE
LAKELAND, FL
ZIP 33805-017
Phone: (863) 519-0575
Fax: (863) 582-9251

The enumeration date for this NPI number is 2/9/2011 and was last updated on 6/22/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental HealthMH8819FLORIDAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1004724100MEDICAIDFLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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