Provider Demographics
NPI:1831989318
Name:KERKHOFF, KELLI N (LPC-A)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:N
Last Name:KERKHOFF
Suffix:
Gender:
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 BEARGRASS LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-6954
Mailing Address - Country:US
Mailing Address - Phone:910-515-5886
Mailing Address - Fax:
Practice Address - Street 1:119 BEARGRASS LN
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-6954
Practice Address - Country:US
Practice Address - Phone:910-515-5886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10381101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health