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Individual
MRS. SUZANNE AUTREY KELLY
Active
Individual
MRS. SUZANNE AUTREY KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC,LCAS,CEAP
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
60
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
1223
NC
101YP2500X
Professional Counselor
Primary
1070
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1005H
BCBS OF NORTH CAROLINA
NC
05
—
6112226
—
NC
Enumeration date
01/03/2006
Last updated
08/14/2025
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