MEDICARE: KELLY SUNDERLAND CHOY MA, LCMHCA, NCC, BSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	A21889	NC

General Provider Information

NPI Number	:	1164387049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY SUNDERLAND CHOY MA, LCMHCA, NCC, BSN

Provider Business Mailing Address
First Line	:	1433 EMERYWOOD DR STE B2
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-4105
Country	:	US
Telephone Number	:	704-659-6686
Fax Number	:

Provider Business Practice Location Address
First Line	:	1433 EMERYWOOD DR STE B2
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28210-4105
Country	:	US
Telephone Number	:	704-659-6686
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2025
Last Update Date	:	12/22/2025

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