Provider Demographics
NPI:1760750434
Name:WESTER, KELLY LYNN (PHD, LPC)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:LYNN
Last Name:WESTER
Suffix:
Gender:F
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 HERRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GRAHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27253-8407
Mailing Address - Country:US
Mailing Address - Phone:336-226-8708
Mailing Address - Fax:
Practice Address - Street 1:231 N SPRING ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27401-2231
Practice Address - Country:US
Practice Address - Phone:336-899-8800
Practice Address - Fax:336-899-8811
Is Sole Proprietor?:No
Enumeration Date:2011-12-08
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4748101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health