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KELLY ROCHELLE TAVENNER LMFT
NPI 1659003473
Marriage & Family Therapist in Laguna Hills, CA

Active since June 29, 2022PECOS Enrolled
23161 MILL CREEK DR STE 230, LAGUNA HILLS, CA 92653(949) 264-5350(949) 221-6939 Get Directions Write a Review

NPPES record last updated: May 29, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Kelly Rochelle Tavenner Lmft NPPES

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

KELLY ROCHELLE TAVENNER LMFT (NPI 1659003473) is an individual marriage & family therapist in Laguna Hills, California, licensed in California (146902) and active in the NPI registry since June 2022. She is enrolled in Medicare PECOS and maintains a secondary practice location in Garden Grove.

NPPES Registry Identity

NPI1659003473
Entity TypeIndividualFemale
Primary Taxonomy106H00000X
Provider Legal NameKELLY ROCHELLE TAVENNERCredential: LMFT
Location Address23161 MILL CREEK DR STE 230Laguna Hills, CA 92653-7935
Mailing Address23161 Mill Creek Dr Ste 230Laguna Hills, CA 92653-7935 · (949) 264-5350 · Fax (949) 221-6939
Phone(949) 264-5350
Fax(949) 221-6939
Sole ProprietorNo
Enumeration DateJune 29, 2022
Last NPPES UpdateMay 29, 2024
NPPES CertifiedMay 29, 2024
✔ NPI 1659003473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyMarriage & Family TherapistBehavioral Health & Social Service Providers
Taxonomy Code106H00000X
License✔ Licensed in CA · 146902
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.
23161 MILL CREEK DR STE 230, Laguna Hills, CA 92653
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Secondary Practice Location 1

Location 112141 Brookhurst St Ste 201Garden Grove, CA 92840-2865 · Phone (657) 261-7140 · Fax (714) 922-1032

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Rochelle Tavenner Lmft is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Kelly Tavenner reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Telecare Corporation
3.0 mi
Psychiatric Residential Treatment Facility
25402 PACIFICA AVE
Mission Viejo, CA 92691
  • Reassigned Medicare billing, California enrollment
  • 247 clinicians in this Medicare group
NPI 1942737648 (949) 238-2400

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 9

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

PRISCILLA FRANCO
Counselor (Mental Health)
23161 MILL CREEK DR STE 230
LAGUNA HILLS, CA 92653
Orange County (949) 264-5350
CHRISTIAN LOUIS LARA
Licensed Psychiatric Technician
23161 MILL CREEK DR STE 230
LAGUNA HILLS, CA 92653
Orange County (657) 261-7140
MARIBEL CONTRERAS
Community Health Worker
23161 MILL CREEK DR STE 230
LAGUNA HILLS, CA 92653
Orange County (949) 264-5350
VANESSA MARIE MCCREERY LPT
Licensed Psychiatric Technician
23161 MILL CREEK DR STE 230
LAGUNA HILLS, CA 92653
Orange County (949) 264-5350
ROXANNA THEOFANOUS MSW
Social Worker
23161 MILL CREEK DR STE 230
LAGUNA HILLS, CA 92653
Orange County (949) 264-5350
JONATHAN EDWARD LUCERO LMFT
Marriage & Family Therapist
23161 MILL CREEK DR STE 230
LAGUNA HILLS, CA 92653
Orange County (949) 264-5350
ASHANTI JONES
Counselor (Mental Health)
23161 MILL CREEK DR STE 230
LAGUNA HILLS, CA 92653
Orange County (949) 264-5350
ARIANNA OSBORNE
Licensed Psychiatric Technician
23161 MILL CREEK DR STE 230
LAGUNA HILLS, CA 92653
Orange County (949) 264-5350

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 Kelly Tavenner's NPI number?

The NPI number for Kelly Tavenner is 1659003473. It was assigned to this individual provider in the NPPES registry on June 29, 2022.

Where is Kelly Tavenner located?

Kelly Tavenner practices at 23161 Mill Creek Dr Ste 230, Laguna Hills, CA 92653. The listed phone number is (949) 264-5350.

What is Kelly Tavenner's specialty?

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

Is Kelly Tavenner enrolled in Medicare?

Yes. Kelly Tavenner is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kelly Tavenner's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Tavenner reassigns Medicare benefits to Telecare Corporation (Mission Viejo, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Tavenner's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Kelly Tavenner was last updated on May 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.