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BREANNA KELLY LCSW
NPI 1871047720
Behavior Analyst in Decatur, GA

Active since August 09, 2016PECOS EnrolledAccepts Medicare Assignment
PO BOX 371091, DECATUR, GA 30037(813) 361-0596 Get Directions Write a Review

NPPES record last updated: June 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 2, 2025, Jan 29, 2019, Jan 9, 2019 and 2 more (5 updates tracked since 2016).

About Breanna Kelly Lcsw NPPES

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

BREANNA KELLY LCSW (NPI 1871047720) is an individual behavior analyst provider in Decatur, Georgia, licensed in (11833409) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Decatur, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1871047720
Entity TypeIndividualFemale
Primary Taxonomy103K00000X
Provider Legal NameBREANNA KELLYCredential: LCSW
Location AddressPO BOX 371091Decatur, GA 30037-1091
Mailing Address4026 Birchwood CvDecatur, GA 30034-5251 · (813) 361-0596
Phone(813) 361-0596
Sole ProprietorNo
Medical School CMSOtherGraduated 2017
Enumeration DateAugust 9, 2016
Last NPPES UpdateJune 2, 20255 updates tracked since enumeration
NPPES CertifiedJune 2, 2025
✔ NPI 1871047720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyBehavior AnalystBehavioral Health & Social Service Providers
Taxonomy Code103K00000X
License✔ Licensed · 11833409
Definition
A behavior analyst is qualified by at least a master's degree and Behavior Analyst Certification Board certification and/or a state-issued credential (such as a license) to practice behavior analysis independently. Behavior analysts provide the required supervision to assistant behavior analysts and behavior technicians. A behavior analyst delivers services consistent with the dimensions of applied behavior analysis. Common services may include, but are not limited to, conducting behavioral assessments, analyzing data, writing and revising behavior-analytic treatment plans, training others to implement components of treatment plans, and overseeing implementation of treatment plans.
Also ListedSocial WorkerTaxonomy 104100000X · License MSW006385 (GA)
Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X · License CSW005955 (GA)
PO BOX 371091, Decatur, GA 30037
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Secondary Practice Location 1

Location 12319 Wingfoot PlDecatur, GA 30035-2812 · Phone (813) 361-0596

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

Breanna Kelly Lcsw 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 ID9436689338
PECOS Enrollment IDI20250207000186
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.

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 Breanna Kelly's NPI number?

The NPI number for Breanna Kelly is 1871047720. It was assigned to this individual provider in the NPPES registry on August 9, 2016.

Where is Breanna Kelly located?

Breanna Kelly practices at PO Box 371091, Decatur, GA 30037. The listed phone number is (813) 361-0596.

What is Breanna Kelly's specialty?

The primary specialty registered for this NPI is Behavior Analyst with taxonomy code 103K00000X.

Is Breanna Kelly enrolled in Medicare?

Yes. Breanna Kelly 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.

When was this NPI record last updated?

The NPPES record for Breanna Kelly was last updated on June 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.