Individual
IRVING KELLEY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3500 POPE ST SE, WASHINGTON, DC 20020-2356
(202) 439-9123
Mailing address
3500 POPE ST SE, WASHINGTON, DC 20020-2356
(202) 439-9123
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LGPC00181
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1903
BUSINESS
—
01
—
1973
BUSINESS
—
Enumeration date
10/12/2018
Last updated
10/12/2018
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