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General NPI Number Information
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NPI Number | 1073372678
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Entity Type | Individual
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Provider Name | NICALONDRIA KELLEY LPC
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Gender | Female
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Dates
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Enumeration Date | 03/15/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 20008 CHAMPION FOREST DR STE 601
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City | SPRING
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State | TX
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Zip | 77379-8696
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Country | US
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Telephone | 281-892-9986
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Fax |
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Provider Business Mailing Address
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Address Line | 14410 KERRICK VISTA LN
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City | CONROE
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State | TX
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Zip | 77384-1514
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Country | US
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Telephone | 281-901-4043
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 85258
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License Number State | TX
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