MEDICARE: KATHRYN KELLEY MSW, LCSWA, LCAS

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	1041C0700X	Clinical Social Worker	P017207	NC
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	LCAS-27299	NC

General Provider Information

NPI Number	:	1437824786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHRYN KELLEY MSW, LCSWA, LCAS

Provider Business Mailing Address
First Line	:	80 LOUISIANA AVE
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-3448
Country	:	US
Telephone Number	:	603-247-0850
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 LOUISIANA AVE
Second Line	:
City	:	ASHEVILLE
State	:	NC
Zip	:	28806-3448
Country	:	US
Telephone Number	:	603-247-0850
Fax Number	:

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

Provider Enumeration Date	:	08/10/2021
Last Update Date	:	04/23/2026

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