Individual
KELLY F SEVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2017 JEFFERSON ST SW, ROANOKE, VA 24014-2419
(540) 853-0900
(540) 853-0518
Mailing address
213 S JEFFERSON ST, SUITE 625, ROANOKE, VA 24011-1700
(540) 224-5681
(540) 224-5684
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904007302
VA
Other
Enumeration date
01/22/2010
Last updated
01/22/2010
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