Provider Demographics
NPI:1821488222
Name:CENTER, KELLI T (LPC)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:T
Last Name:CENTER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3355 LENOX RD NE STE 1000
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30326-2000
Mailing Address - Country:US
Mailing Address - Phone:602-809-0816
Mailing Address - Fax:855-436-5564
Practice Address - Street 1:3355 LENOX RD NE STE 1000
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-2000
Practice Address - Country:US
Practice Address - Phone:800-204-4195
Practice Address - Fax:855-436-5564
Is Sole Proprietor?:No
Enumeration Date:2015-01-23
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-15353101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional