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General NPI Number Information
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NPI Number | 1023822889
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Entity Type | Individual
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Provider Name | MARGARET GRAVELY KELLOGG LPC
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Gender | Female
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Dates
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Enumeration Date | 02/03/2025
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Last Update Date | 02/04/2026
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Provider Practice Location Address
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Address Line | 620 MOOREFIELD PARK DR STE 140
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City | NORTH CHESTERFIELD
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State | VA
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Zip | 23236-3692
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Country | US
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Telephone | 804-719-1966
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Fax |
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Provider Business Mailing Address
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Address Line | 6841 FOREST HILL AVE
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City | RICHMOND
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State | VA
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Zip | 23225-1603
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Country | US
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Telephone | 804-339-9780
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0701014256
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License Number State | VA
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