Provider Demographics
NPI:1861171472
Name:JARRETT, KELLEY SPEARS (LCMHC, NCC, MA)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:SPEARS
Last Name:JARRETT
Suffix:
Gender:F
Credentials:LCMHC, NCC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1271 10TH ST NW
Mailing Address - Street 2:
Mailing Address - City:HICKORY
Mailing Address - State:NC
Mailing Address - Zip Code:28601-2420
Mailing Address - Country:US
Mailing Address - Phone:828-302-5032
Mailing Address - Fax:
Practice Address - Street 1:321 7TH ST NE STE B
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-5154
Practice Address - Country:US
Practice Address - Phone:828-485-2195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-12
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13711101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health