Provider Demographics
NPI:1356017404
Name:GULDIN, KELLY PARRISH (MS, LPC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:PARRISH
Last Name:GULDIN
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4040 INDEPENDENCE DR NW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35816-3012
Mailing Address - Country:US
Mailing Address - Phone:256-721-1940
Mailing Address - Fax:256-721-1934
Practice Address - Street 1:4040 INDEPENDENCE DR NW
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35816-3012
Practice Address - Country:US
Practice Address - Phone:256-721-1940
Practice Address - Fax:256-721-1934
Is Sole Proprietor?:No
Enumeration Date:2021-08-18
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3268101YM0800X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health