Healthcare Provider Details

I. General information

NPI: 1588991483
Provider Name (Legal Business Name): KARIA BRYN KELCH-OLIVER PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. KARIA BRYN ROBESON KELCH

II. Dates (important events)

Enumeration Date: 11/13/2009
Last Update Date: 04/13/2022
Certification Date: 04/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CUMBERLAND PARKWAY KAISER PERMANENTE CUMBERLAND MEDICAL CENTER
ATLANTA GA
30339
US

IV. Provider business mailing address

3495 PIEDMONT ROAD, NE NINE PIEDMONT CENTER
ATLANTA GA
30305
US

V. Phone/Fax

Practice location:
  • Phone: 770-431-4235
  • Fax: 404-752-1191
Mailing address:
  • Phone: 404-364-7070
  • Fax: 404-756-1402

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFT000991
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY003348
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: