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General NPI Number Information
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NPI Number | 1174115075
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Entity Type | Individual
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Provider Name | KELSEY LEIGH MILAM MSW, LCSW, CCTP
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Gender | Female
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Dates
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Enumeration Date | 02/11/2021
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Last Update Date | 11/29/2022
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Provider Practice Location Address
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Address Line | 3041 BERKS WAY STE 204
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City | RALEIGH
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State | NC
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Zip | 27614-6777
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Country | US
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Telephone | 919-647-4600
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Fax |
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Provider Business Mailing Address
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Address Line | 3041 BERKS WAY STE 204
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City | RALEIGH
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State | NC
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Zip | 27614-6777
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Country | US
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Telephone | 919-647-4600
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P013252
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 10172-C
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | C015170
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License Number State | NC
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