KELLY PEMBERTON LMFT #100286 - NPI 1225470503 - Marriage & Family Therapist in Sacramento, CA

Q: What is Kelly Pemberton's NPI number?

The NPI number for Kelly Pemberton is 1225470503. It was assigned to this individual provider in the NPPES registry on July 26, 2013.

Q: What is Kelly Pemberton's specialty?

The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.

Q: Is Kelly Pemberton enrolled in Medicare?

No. Kelly Pemberton has opted out of Medicare through January 1, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

Q: When was this NPI record last updated?

The NPPES record for Kelly Pemberton was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

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About Kelly Pemberton Lmft #100286 NPPES

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

KELLY PEMBERTON LMFT #100286 (NPI 1225470503) is an individual marriage & family therapist in Sacramento, California and active in the NPI registry since July 2013. She has opted out of Medicare through January 1, 2028 and maintains a secondary practice location in Placerville.

NPPES Registry Identity

NPI1225470503

Entity TypeIndividualFemale

Primary Taxonomy106H00000X

Provider Legal NameKELLY PEMBERTONCredential: LMFT #100286

Location Address2701 I STSacramento, CA 95816-4309

Mailing AddressPo Box 19002Sacramento, CA 95819-0002 · (916) 668-0297

Phone(916) 668-0297

Sole ProprietorYes

Enumeration DateJuly 26, 2013

Last NPPES UpdateJuly 21, 20223 updates tracked since enumeration

✔ NPI 1225470503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers

Taxonomy Code106H00000X

Definition

A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups.

2701 I ST, Sacramento, CA 95816

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Secondary Practice Location 1

Location 16765 Green Valley RdPlacerville, CA 95667-8984 · Phone (530) 622-5551 · Fax (530) 622-5800

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kelly Pemberton Lmft #100286 has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2028.

Opt-Out Effective DateJanuary 1, 2024

Opt-Out In Effect ThroughJanuary 1, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 8

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

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