Provider Demographics
NPI:1437824786
Name:KELLEY, KATHRYN (MSW, LCSWA, LCAS)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:KELLEY
Suffix:
Gender:F
Credentials:MSW, LCSWA, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 CENTRAL AVE STE C
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2451
Mailing Address - Country:US
Mailing Address - Phone:828-393-0902
Mailing Address - Fax:
Practice Address - Street 1:77 CENTRAL AVE STE C
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-2451
Practice Address - Country:US
Practice Address - Phone:828-393-0902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-10
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0172071041C0700X
NCLCAS-27299101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical