MRS. JAMILLAH A. JACKSON KELLY MS/EDS NCC LCMHCS NPI 1235463308

NPI Information

  • NPI: 1235463308
  • Provider Name: MRS. JAMILLAH A. JACKSON KELLY, MS/EDS, NCC, LCMHCS
  • Classification: Counselor - 101YP2500X
  • Specialization: Professional
  • Entity Type: Individual
  • Address: 4600 EMPEROR BLVD
    DURHAM, NC
    ZIP 27703
  • Phone: (919) 651-8558

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NPI Details

MRS. Jamillah A. Jackson Kelly, MS/EDS, NCC, LCMHCS is a professional counselor in Durham, NC. MRS. Jamillah A. Jackson Kelly, MS/EDS, NCC, LCMHCS NPI is 1235463308. 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:

4600 EMPEROR BLVD
DURHAM, NC
ZIP 27703-577
Phone: (919) 651-8558

The enumeration date for this NPI number is 9/23/2009 and was last updated on 11/19/2024.

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
1101Y00000XCounselor8340NORTH CAROLINANo
2101YA0400XCounselorAddiction (Substance Use Disorder)No
3101YM0800XCounselorMental Health8340NORTH CAROLINANo
4374J00000XDoulaNo
5101YP2500XCounselorProfessional8340NORTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1246803OTHERNATIONAL BOARD FOR CERTIFIED COUNSELORS, INC.
2S8340OTHERNORTH CAROLINATHE NC BOARD OF LICENSED CLINICAL MENTAL HEALTH COUNSELORS
3511277OTHERNATIONAL CERTIFICATION COMMISSION FOR ADDICTION PROFESSIONALS
48340OTHERNORTH CAROLINATHE NC BOARD OF LICENSED PROFESSIONAL COUNSELORS

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: 3/30/2025

NPI Synchronization or Removal

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