Provider Demographics
NPI:1356678130
Name:PHELPS, KELLY ANN (LPC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:PHELPS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:750 W US HIGHWAY 64
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-8115
Mailing Address - Country:US
Mailing Address - Phone:828-837-0071
Mailing Address - Fax:828-837-5309
Practice Address - Street 1:91 TIMBERLANE RD
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-7927
Practice Address - Country:US
Practice Address - Phone:828-454-1098
Practice Address - Fax:877-346-1089
Is Sole Proprietor?:No
Enumeration Date:2009-11-16
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7586101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6104536Medicaid
NC168CYOtherBCBS