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KELLEY WILSON
NPI 1104244474
Counselor - Mental Health in Bradenton, FL

Active since April 02, 2014PECOS EnrolledAccepts Medicare Assignment
5131 MANATEE AVE W, BRADENTON, FL 34209(941) 792-0802 Get Directions Write a Review

NPPES record last updated: April 2, 2014. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kelley Wilson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLEY WILSON (NPI 1104244474) is an individual mental health provider in Bradenton, Florida, licensed in Florida (MH7200) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS and is a graduate of Other (1991).

NPPES Registry Identity

NPI1104244474
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKELLEY WILSON
Location Address5131 MANATEE AVE WBradenton, FL 34209-3740
Mailing Address7406 Loblolly Bay TrlLakewood Ranch, FL 34202-4167 · (941) 238-8180
Phone(941) 792-0802
Sole ProprietorNo
Medical School CMSOtherGraduated 1991
Enumeration DateApril 2, 2014
✔ NPI 1104244474 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in FL · MH7200
5131 MANATEE AVE W, Bradenton, FL 34209
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company), UnitedHealthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelley Wilson is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9133526726
PECOS Enrollment IDI20250310000215
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KRISTIN SANDUSKY
Counselor (Mental Health)
5131 MANATEE AVE W
BRADENTON, FL 34209
Manatee County (941) 792-0802
KARIN SCHWIETZ LMHC
Counselor (Mental Health)
5131 MANATEE AVE W
BRADENTON, FL 34209
Manatee County (941) 792-0802
AMANDA SHAW MA, LMHC
Counselor (Mental Health)
5131 MANATEE AVE W
BRADENTON, FL 34209
Manatee County (941) 792-0802
BRADENTON COUNSELING CENTER, INC.
Counselor (Mental Health)
5131 MANATEE AVE W
BRADENTON, FL 34209
Manatee County (941) 792-0802
JANE ANN PAVICH LCSW
Social Worker (Clinical)
5131 MANATEE AVE W
BRADENTON, FL 34209
Manatee County (941) 792-0802

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelley Wilson's NPI number?

The NPI number for Kelley Wilson is 1104244474. It was assigned to this individual provider in the NPPES registry on April 2, 2014.

Where is Kelley Wilson located?

Kelley Wilson practices at 5131 Manatee Ave W, Bradenton, FL 34209. The listed phone number is (941) 792-0802.

What is Kelley Wilson's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kelley Wilson enrolled in Medicare?

Yes. Kelley Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kelley Wilson accept?

Health plans from Florida Blue (BlueCross BlueShield FL), Florida Blue HMO (a BlueCross BlueShield FL company) and UnitedHealthcare list Kelley Wilson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kelley Wilson was last updated on April 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.