Individual
MRS. KELLY JO HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
3149 OLD CLARKSVILLE SPGFLD RD, ADAMS, TN 37010-8908
(910) 644-2410
Mailing address
3149 OLD CLARKSVILLE SPGFLD RD, ADAMS, TN 37010-8908
(910) 644-2410
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
19353
CO
101Y00000X
Counselor
6609
TN
101YP2500X
Professional Counselor
Primary
13233
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13233
LPC
NC
01
—
19353
LPC
CO
01
—
6609
LPC
TN
Enumeration date
08/22/2007
Last updated
08/09/2024
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