MRS. KELLY SHEPPARD PRUITT LCMHC NPI 1962172916

NPI Information

NPI: 1962172916
Provider Name: MRS. KELLY SHEPPARD PRUITT, LCMHC
Classification: Counselor - 101YM0800X
Entity Type: Individual

Specialization: Mental Health

Address:
1255 CREEKSHIRE WAY STE 270
WINSTON SALEM, NC
ZIP 27103
Phone: (336) 283-4757
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MRS. Kelly Sheppard Pruitt, LCMHC is a mental health counselor in Winston Salem, NC. MRS. Kelly Sheppard Pruitt, LCMHC NPI is 1962172916. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1255 CREEKSHIRE WAY STE 270
WINSTON SALEM, NC
ZIP 27103-061
Phone: (336) 283-4757

The enumeration date for this NPI number is 9/20/2021 and was last updated on 9/20/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YM0800X	Counselor	Mental Health	12644	NORTH CAROLINA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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