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Individual

MS. GAHAN C KELLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
2000 RIVERSIDE DRIVE, #10R, RICHMOND, VA 23225
(804) 837-7125
Mailing address
2000 RIVERSIDE DRIVE, #10R, RICHMOND, VA 23225
(804) 837-7125

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904005859
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080082M
SENTARA
VA
01
145396
ANTHEM
VA
05
4945280
VA
Enumeration date
06/22/2006
Last updated
02/22/2024
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