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

Q: 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.

Q: What is Kelly Tavenner's specialty?

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

Q: 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.

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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, and ordering and referring status from the CMS PECOS system.

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.

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)