Provider Demographics
NPI:1689318057
Name:CORE, KELSEY L
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:L
Last Name:CORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 OLD MARS HILL HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-8628
Mailing Address - Country:US
Mailing Address - Phone:828-645-3687
Mailing Address - Fax:
Practice Address - Street 1:901 OLD MARS HILL HWY STE 3
Practice Address - Street 2:
Practice Address - City:WEAVERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28787-8628
Practice Address - Country:US
Practice Address - Phone:828-645-3687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)