MEDICARE: KEM WELLNESS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
2	261QM0850X	Adult Mental Health Clinic/Center
3	261QM0855X	Adolescent and Children Mental Health Clinic/Center
4	251B00000X	Case Management Agency
5	101YM0800X	Mental Health Counselor
6	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1457246621
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KEM WELLNESS, LLC

Provider Business Mailing Address
First Line	:	13747 MONTFORT DR STE 350
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4488
Country	:	US
Telephone Number	:	972-861-2713
Fax Number	:

Provider Business Practice Location Address
First Line	:	13747 MONTFORT DR STE 350
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75240-4488
Country	:	US
Telephone Number	:	972-861-2713
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	KRISTINA MCCRAY
Credential	:
Telephone Number	:	972-861-2713

Provider Enumeration Date	:	06/10/2025
Last Update Date	:	01/02/2026

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