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General NPI Number Information
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NPI Number | 1558490318
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Entity Type | Individual
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Provider Name | JANICE EILEEN KILEY MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 03/05/2007
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Last Update Date | 04/20/2020
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Provider Practice Location Address
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Address Line | 196 OLD STAGECOACH LN
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City | STATESVILLE
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State | NC
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Zip | 28625-1594
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Country | US
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Telephone | 631-806-6693
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Fax |
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Provider Business Mailing Address
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Address Line | 17915 GOLDEN MEADOW CT
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City | DAVIDSON
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State | NC
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Zip | 28036-7870
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Country | US
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Telephone | 704-896-8901
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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 | C006350
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 067431
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | B000617
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | P003932
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License Number State | NC
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