Provider Demographics
NPI:1851651756
Name:KELLEY, ERIN CULHAN (LMFT)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:CULHAN
Last Name:KELLEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 LYNCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-3941
Mailing Address - Country:US
Mailing Address - Phone:504-239-6773
Mailing Address - Fax:
Practice Address - Street 1:3505 PELHAM RD STE B-1
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4114
Practice Address - Country:US
Practice Address - Phone:864-788-1210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
CO0001464106H00000X
SC7030106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)