Provider Demographics
NPI:1730444811
Name:TOOMEY, KELSEY (MA, LPA)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:TOOMEY
Suffix:
Gender:F
Credentials:MA, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1955
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27512-1955
Mailing Address - Country:US
Mailing Address - Phone:919-622-1303
Mailing Address - Fax:
Practice Address - Street 1:4917 WATERS EDGE DR STE 220
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27606-2459
Practice Address - Country:US
Practice Address - Phone:704-622-1303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2017-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4308103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist