Provider Demographics
NPI:1447753686
Name:SHELTON, KELLI M (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:M
Last Name:SHELTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 A GOVERNOR'S SQ.
Mailing Address - Street 2:
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269
Mailing Address - Country:US
Mailing Address - Phone:678-364-1300
Mailing Address - Fax:678-364-1352
Practice Address - Street 1:145 A GOVERNOR'S SQ.
Practice Address - Street 2:
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269
Practice Address - Country:US
Practice Address - Phone:678-364-1300
Practice Address - Fax:678-364-1352
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LPC008325101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional