Individual
MRS. KELLY MAE VAN VLEET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.A., LCMHC, LCAS
Contact information
Practice address
8003 HYDE PARK DR, INDIAN TRAIL, NC 28079-5657
(336) 259-3590
Mailing address
8003 HYDE PARK DR, INDIAN TRAIL, NC 28079-5657
(336) 259-3590
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1981
NC
101YM0800X
Mental Health Counselor
Primary
8870
NC
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
03/03/2011
Last updated
03/23/2026
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