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Individual

MRS. JAMILLAH A. JACKSON KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS/EDS, NCC, LCMHCS

Contact information

Practice address
4600 EMPEROR BLVD, DURHAM, NC 27703-8577
(919) 651-8558
Mailing address
329 PEACH HILL LN, HOLLY SPRINGS, NC 27540-5428
(336) 327-7361

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
8340
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
8340
NC
101YP2500X
Professional Counselor
Primary
8340
NC
374J00000X
Doula

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
246803
NATIONAL BOARD FOR CERTIFIED COUNSELORS, INC.
01
511277
NATIONAL CERTIFICATION COMMISSION FOR ADDICTION PROFESSIONALS
01
8340
THE NC BOARD OF LICENSED PROFESSIONAL COUNSELORS
NC
01
S8340
THE NC BOARD OF LICENSED CLINICAL MENTAL HEALTH COUNSELORS
NC
Enumeration date
09/23/2009
Last updated
11/19/2024
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