Provider Demographics
NPI:1598213993
Name:JOYCE, KELLY WELCH (LCMHC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:WELCH
Last Name:JOYCE
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:MARIE
Other - Last Name:WELCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCMHC
Mailing Address - Street 1:809 SMOKE TREE CIR
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27023-8609
Mailing Address - Country:US
Mailing Address - Phone:704-491-5360
Mailing Address - Fax:
Practice Address - Street 1:1336 WESTGATE CENTER DR
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-2933
Practice Address - Country:US
Practice Address - Phone:336-422-6288
Practice Address - Fax:844-440-2408
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12752101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health