Provider Demographics
NPI:1982195509
Name:GARNER, KELSEY LUVENDER (MED, NCC, LCMHC)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:LUVENDER
Last Name:GARNER
Suffix:
Gender:F
Credentials:MED, NCC, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8013 MORGANS WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-2527
Mailing Address - Country:US
Mailing Address - Phone:252-412-2613
Mailing Address - Fax:
Practice Address - Street 1:715 W MORGAN ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1611
Practice Address - Country:US
Practice Address - Phone:919-823-6724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-21
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12492101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health