Healthcare Provider Details

I. General information

NPI: 1184376865
Provider Name (Legal Business Name): KAILEE DULANY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2022
Last Update Date: 05/13/2025
Certification Date: 05/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

280 CONCORD PKWY S STE 100
CONCORD NC
28027-2705
US

IV. Provider business mailing address

280 CONCORD PKWY S STE 100
CONCORD NC
28027-2705
US

V. Phone/Fax

Practice location:
  • Phone: 980-209-6328
  • Fax: 704-787-8085
Mailing address:
  • Phone: 980-209-6328
  • Fax: 704-787-8085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC018343
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: