Healthcare Provider Details

I. General information

NPI: 1831253095
Provider Name (Legal Business Name): BRITTANY J KELLY MA, CDCA, LPCC, LCDC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 CROCKER RD
WESTLAKE OH
44145-6314
US

IV. Provider business mailing address

PO BOX 1075
COLUMBIA STATION OH
44028-1075
US

V. Phone/Fax

Practice location:
  • Phone: 440-529-9419
  • Fax: 440-588-8674
Mailing address:
  • Phone: 440-529-9419
  • Fax: 440-588-8674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number101043
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE0008042
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberE0008042
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: