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General NPI Number Information
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NPI Number | 1780209528
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Entity Type | Organization
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Legal Business Name | KELLI WRIGHT COUNSELING, LLC
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Dates
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Enumeration Date | 06/08/2020
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Last Update Date | 06/08/2020
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Provider Practice Location Address
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Address Line | 496 HIGHWAY 67 S STE A
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City | DECATUR
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State | AL
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Zip | 35603-6300
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Country | US
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Telephone | 256-584-2119
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Fax |
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Provider Business Mailing Address
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Address Line | 1025 COUNTY ROAD 376
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City | CRANE HILL
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State | AL
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Zip | 35053-3379
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Country | US
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Telephone | 256-584-2119
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Fax |
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | MRS. KELLI WRIGHT
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Credential | LICSW
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Telephone | 256-584-2119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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