Provider Demographics
NPI:1255649554
Name:KELLEY, YULONDA YVETTE (MA,LPC)
Entity Type:Individual
Prefix:
First Name:YULONDA
Middle Name:YVETTE
Last Name:KELLEY
Suffix:
Gender:F
Credentials:MA,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1174 MAPLE WALK CIR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-2275
Mailing Address - Country:US
Mailing Address - Phone:404-375-5273
Mailing Address - Fax:678-701-1644
Practice Address - Street 1:315 W PONCE DE LEON AVE STE 545
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-2448
Practice Address - Country:US
Practice Address - Phone:404-375-5273
Practice Address - Fax:678-701-1644
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-21
Last Update Date:2012-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006635101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional