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NPI Code Detail

MEDICARE: KELLI WOOD LCSW

MEDICARE:   KELLI  WOOD  LCSW
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
11041C0700XClinical Social WorkerC008506NC

General Provider Information

NPI Number : 1386501484
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLI WOOD LCSW
Provider Business Mailing Address
First Line : PO BOX 62
Second Line :
City : FORT MILL
State : SC
Zip : 29716-0062
Country : US
Telephone Number : 678-266-8635
Fax Number :
Provider Business Practice Location Address
First Line : 1513 FLORIDA ST
Second Line :
City : GASTONIA
State : NC
Zip : 28052-0704
Country : US
Telephone Number : 678-266-8635
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2026
Last Update Date : 01/10/2026

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Directions to “ KELLI WOOD LCSW” Practice Location

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