Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Carissa Kelly

Individual provider Behavior Technician · NPI 1104424456

Carissa Kelly is a Behavior Technician in Port St Lucie, Florida. Practices as a sole proprietor and works from 2 locations. Registered with an NPI since 2020.

In the registry since
2020
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Practice location Address checks out

1887 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5530
Phone: (772) 463-0444
Fax: (772) 219-1339
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5000 Stonewood Dr, Wexford, PA 15090-8395 — (724) 933-4673

Specialties & licences

Behavior Technician (primary) Taxonomy 106S00000X

Record details

NPI number1104424456
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 9, 2020
Last updated in NPPESSeptember 29, 2022
Certification dateSeptember 29, 2022

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