Provider Demographics
NPI:1952053498
Name:LAROWE, KELLY LYNN (CPSS, CADC)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:LYNN
Last Name:LAROWE
Suffix:
Gender:F
Credentials:CPSS, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 799
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:NC
Mailing Address - Zip Code:28760-0799
Mailing Address - Country:US
Mailing Address - Phone:828-707-2365
Mailing Address - Fax:
Practice Address - Street 1:170 OLD NAPLES RD STE A
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-8613
Practice Address - Country:US
Practice Address - Phone:828-707-2365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-26
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCADC-25596101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)