Individual
CHRISTOPHER CARR KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
1601 SW ARCHER RD, GAINESVILLE, FL 32608-1197
(352) 376-1611
Mailing address
1601 SW ARCHER RD, GAINESVILLE, FL 32608-1197
(352) 376-1611
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
SW7406
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001499-07
—
FL
Enumeration date
04/02/2007
Last updated
12/03/2018
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