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KELLY LANE LPC
NPI 1699447052
Counselor - Mental Health in Mentor, OH

Active since October 04, 2021PECOS Enrolled
7232 JUSTIN WAY, MENTOR, OH 44060(440) 578-8200 Get Directions Write a Review

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

About Kelly Lane Lpc NPPES

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

KELLY LANE LPC (NPI 1699447052) is an individual mental health provider in Mentor, Ohio, licensed in Ohio (C2103787) and active in the NPI registry since October 2021. She is enrolled in Medicare PECOS, maintains a secondary practice location in North Ridgeville, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1699447052
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKELLY LANECredential: LPC
Location Address7232 JUSTIN WAYMentor, OH 44060-4881
Mailing Address35888 Center Ridge Rd Ste 5North Ridgeville, OH 44039-3086 · (440) 327-1800 · Fax (440) 327-1533
Phone(440) 578-8200
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateOctober 4, 2021
Last NPPES UpdateAugust 29, 2024
NPPES CertifiedAugust 29, 2024
✔ NPI 1699447052 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 OH · C2103787
7232 JUSTIN WAY, Mentor, OH 44060
Open in Google Maps ↗

Secondary Practice Location 1

Location 135888 Center Ridge Rd Ste 5North Ridgeville, OH 44039-3086 · Phone (440) 327-1800 · Fax (440) 327-1533

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Kelly Lane Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6103308556
PECOS Enrollment IDI20260304003256
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 Lane reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Signature Health, Inc
2.6 mi
Mental Health (Including Community Mental Health Center)
38876 MENTOR AVE
Willoughby, OH 44094
  • Reassigned Medicare billing, Ohio enrollment
  • 342 clinicians in this Medicare group
NPI 1477575348 (440) 953-9999

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 20

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

DR. TIFFANY JONES M.D.
Psychiatry & Neurology (Psychiatry)
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
ASHLEY NICHOLE FOCHT
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
MRS. FATIMAAH D FULLILOVE LSW, LICDC
Social Worker (Clinical)
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
THERESA GILL LPCC
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
JAMIE GAMBRELL
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
CLOTILDA J RAYMOND
Social Worker
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
BRENDA BERRY SAMPLE
Case Manager/Care Coordinator
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200
KIMBERLEE BIZUP LPCC-S
Counselor
7232 JUSTIN WAY
MENTOR, OH 44060
Lake County (440) 578-8200

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 Lane's NPI number?

The NPI number for Kelly Lane is 1699447052. It was assigned to this individual provider in the NPPES registry on October 4, 2021.

Where is Kelly Lane located?

Kelly Lane practices at 7232 Justin Way, Mentor, OH 44060. The listed phone number is (440) 578-8200.

What is Kelly Lane's specialty?

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

Is Kelly Lane enrolled in Medicare?

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

Which organization bills Medicare for Kelly Lane's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Lane reassigns Medicare benefits to Signature Health, Inc (Willoughby, OH). 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 Lane's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kelly Lane accept?

Health plans from CareSource list Kelly Lane 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 Kelly Lane was last updated on August 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.