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NPI Code Detail

MEDICARE: KELSEY DOMANN-SCHOLZ LPCA, NCC, MA

MEDICARE:   KELSEY  DOMANN-SCHOLZ  LPCA, NCC, MA
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
1101YM0800XMental Health CounselorA12273NC

General Provider Information

NPI Number : 1447604822
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY DOMANN-SCHOLZ LPCA, NCC, MA
Provider Business Mailing Address
First Line : 1426 IDA ST APT A
Second Line :
City : DURHAM
State : NC
Zip : 27705-3330
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1426 IDA ST APT A
Second Line :
City : DURHAM
State : NC
Zip : 27705-3330
Country : US
Telephone Number : 503-407-1740
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/21/2016
Last Update Date : 04/21/2016

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Directions to “ KELSEY DOMANN-SCHOLZ LPCA, NCC, MA” Practice Location

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