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NPI Code Detail

MEDICARE: MORIAH KELLY

MEDICARE: MORIAH KELLY
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1558212472
Entity Type Code : Individual
Provider Name (Legal Business Name) : MORIAH KELLY
Provider Business Mailing Address
First Line : 3421 MIKE PADGETT HWY
Second Line :
City : AUGUSTA
State : GA
Zip : 30906-3815
Country : US
Telephone Number : 706-432-4837
Fax Number :
Provider Business Practice Location Address
First Line : 3421 MIKE PADGETT HWY
Second Line :
City : AUGUSTA
State : GA
Zip : 30906-3815
Country : US
Telephone Number : 706-432-4837
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2026
Last Update Date : 02/06/2026

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Directions to “ MORIAH KELLY ” Practice Location

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