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

Shelly Marie Kennedy-Gonzalez, LPC

Individual provider Mental Health Counselor · NPI 1679923320

Shelly Marie Kennedy-Gonzalez, LPC is a Mental Health Counselor in Broken Arrow, Oklahoma. Qualified in 2016, 10 years ago. Practices with Evolution Mental Health Services PLLC, a 6-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Oklahoma.

Years since qualifying
10
Licensed in
OK
In the registry since
2016
Specialties on file
2
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

2017 S Elm Pl Ste 104
Broken Arrow, OK 74012-7034
Phone: (918) 379-4431
Fax: (918) 328-2380
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 6931 S 66th East Ave Ste 200, Tulsa, OK 74133-1765 — (918) 379-4431

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 06888 (OK)
Counselor Taxonomy 101Y00000X · Licence 6888 (OK)

Record details

NPI number1679923320
Entity typeIndividual (Type 1)
GenderFemale
Credentials LPC
Sole proprietorNo
NPI enumeratedJune 14, 2016
Last updated in NPPESNovember 8, 2025
Certification dateNovember 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Evolution Mental Health Services Pllc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Broken Arrow