Organization
KELLY COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERWIN KELLY LCMHC (EXECUTIVE DIRECTOR)
(910) 261-1085
Entity
Organization
Contact information
Practice address
351 WAGONER DR STE 410, FAYETTEVILLE, NC 28303-4670
(910) 261-1085
Mailing address
351 WAGONER DR STE 410, FAYETTEVILLE, NC 28303-4670
(910) 339-4749
(910) 339-5953
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
—
—
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
09/14/2022
Last updated
05/15/2024
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