Kelley, Mark Andrew

Kelley, Mark Andrew is an individual health care provider with primary practice located at 405 Westwood Ave , High Point NC 27262-4325. He recently has only one registered license in Behavioral Health & Social Service Providers / Marriage & Family Therapist, which is considered as his primary health care specialty. Kelley, Mark Andrew can be contacted via phone (336) 887-7350.

Contact Information

Primary practice address
405 Westwood Ave High Point NC 27262-4325
Phone: (336) 887-7350
Fax: (336) 887-7353
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 4194 North Carolina

Profile Details

NPI number 1902949878
LBN Legal business name Kelley, Mark Andrew
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 14th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902949878 NPPES
North Carolina Other 13323 BCBS PRIVATE INSURANCE
North Carolina MEDICAID 6102011 BCBS PRIVATE INSURANCE
North Carolina Other C5330 BCBS PRIVATE INSURANCE

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