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Individual

CHRISTOPHER KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
630 PARK ST APT B, CHARLOTTESVILLE, VA 22902-4642
(412) 849-1204
Mailing address
4000 CITY WALK WAY, APT. #116, CHARLOTTESVILLE, VA 22902-4642
(412) 849-1204

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0701006537
VA
101YP2500X
Professional Counselor
PC007917
PA
101YP2500X
Professional Counselor
PRC14581
DC

Other

Enumeration date
02/16/2016
Last updated
11/02/2016
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