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General NPI Number Information
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NPI Number | 1093659773
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Entity Type | Organization
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Legal Business Name | KELLY ELEDGE LCSW LLC
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Dates
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Enumeration Date | 04/15/2026
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Last Update Date | 04/15/2026
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Provider Practice Location Address
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Address Line | 350 E ARMOUR BLVD APT 111
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City | KANSAS CITY
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State | MO
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Zip | 64111-1290
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Country | US
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Telephone | 888-289-8856
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Fax |
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Provider Business Mailing Address
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Address Line | 350 E ARMOUR BLVD APT 111
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City | KANSAS CITY
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State | MO
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Zip | 64111-1290
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Country | US
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Telephone | 888-289-8856
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Fax |
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Authorized Official
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Title or Position | MENTAL HEALTH THERAPIST
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Name | MISS KELLY MARIE ELEDGE
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Credential | LCSW
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Telephone | 888-289-8856
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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