Provider Demographics
NPI:1629595426
Name:VIEIRA, KALLY (LMHC, LPCC)
Entity Type:Individual
Prefix:MRS
First Name:KALLY
Middle Name:
Last Name:VIEIRA
Suffix:
Gender:F
Credentials:LMHC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1529 GRAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92078-2464
Mailing Address - Country:US
Mailing Address - Phone:760-798-0299
Mailing Address - Fax:
Practice Address - Street 1:1529 GRAND AVE STE A
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92078-2464
Practice Address - Country:US
Practice Address - Phone:760-798-0299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional