Provider Demographics
NPI:1073709838
Name:KURTTS, KELLI KING (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:KING
Last Name:KURTTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2868 ACTON RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35243-2502
Mailing Address - Country:US
Mailing Address - Phone:205-968-8360
Mailing Address - Fax:
Practice Address - Street 1:1203 US HIGHWAY 98
Practice Address - Street 2:SUITE 2A
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4277
Practice Address - Country:US
Practice Address - Phone:251-621-9167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1762C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical