Provider Demographics
NPI:1366213365
Name:COUNSELING WITH KELLI LLC
Entity type:Organization
Organization Name:COUNSELING WITH KELLI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:S
Authorized Official - Last Name:PALMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:276-403-9110
Mailing Address - Street 1:198 GREEN LEAF CIR
Mailing Address - Street 2:
Mailing Address - City:RIDGEWAY
Mailing Address - State:VA
Mailing Address - Zip Code:24148-3115
Mailing Address - Country:US
Mailing Address - Phone:276-340-6195
Mailing Address - Fax:
Practice Address - Street 1:22 E CHURCH ST STE 310
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-6208
Practice Address - Country:US
Practice Address - Phone:276-403-9110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty