Healthcare Provider Details

I. General information

NPI: 1326459264
Provider Name (Legal Business Name): LISA KELBAUGH LPCA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/14/2014
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 BENSON RD STE 128
GARNER NC
27529-3947
US

IV. Provider business mailing address

500 BENSON RD STE 128
GARNER NC
27529-3947
US

V. Phone/Fax

Practice location:
  • Phone: 919-796-9292
  • Fax:
Mailing address:
  • Phone: 919-796-9292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number8693
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: