Provider Demographics
NPI:1720222359
Name:FRANZONE, KELLY WALLACE (MA, LPC, NCC)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:WALLACE
Last Name:FRANZONE
Suffix:
Gender:F
Credentials:MA, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 6222
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188
Mailing Address - Country:US
Mailing Address - Phone:757-603-4068
Mailing Address - Fax:757-877-3925
Practice Address - Street 1:5209 MONTICELLO AVE.
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188
Practice Address - Country:US
Practice Address - Phone:757-603-4068
Practice Address - Fax:757-877-3925
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-27
Last Update Date:2016-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003888101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional