Healthcare Provider Details

I. General information

NPI: 1174689905
Provider Name (Legal Business Name): KELLY S PLOUFFE LMFT, CCTP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 08/08/2025
Certification Date: 08/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1819 SHORT BRANCH DR STE 103
NEW PORT RICHEY FL
34655-4423
US

IV. Provider business mailing address

1819 SHORT BRANCH DR STE 103
NEW PORT RICHEY FL
34655-4423
US

V. Phone/Fax

Practice location:
  • Phone: 727-810-4851
  • Fax:
Mailing address:
  • Phone: 727-810-4851
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMT2361
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMT946
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: