Provider Demographics
NPI:1720370976
Name:CADILLA, KELLY (LCSW)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:CADILLA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 RIDGEFIELD BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-6209
Mailing Address - Country:US
Mailing Address - Phone:828-670-7723
Mailing Address - Fax:828-670-7727
Practice Address - Street 1:1100 RIDGEFIELD BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806-6209
Practice Address - Country:US
Practice Address - Phone:828-670-7723
Practice Address - Fax:828-670-7727
Is Sole Proprietor?:No
Enumeration Date:2011-05-06
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical