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Mr. Kirk Douglas Kelly
Addiction (Substance Use Disorder) Counselor in Berkeley, California
NPI 1225444201

Kirk Douglas Kelly is an Addiction (Substance Use Disorder) Counselor based in Berkeley, CA and is specialized in Addiction (Substance Use Disorder). Kirk Douglas Kelly practices in Berkeley, CA. The NPI Number for Kirk Douglas Kelly is 1225444201 and holds a License No. (California).

The current practice location address for Kirk Douglas Kelly is 1931 Center St, Berkeley, CA and can be reached out via phone at 408-613-0770 and via fax at 510-666-0987.

Location: 1931 Center St, Berkeley, CA, 94704-1105
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1225444201
Provider Name
Kirk Douglas Kelly
Credential
Provider Entity Type
Individual
Gender
Male
Address
1931 Center St, Berkeley, CA, 94704-1105
Phone Number
408-613-0770
Fax Number
510-666-0987
Provider Enumeration Date
07/10/2014
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00 01 CA 00
institution
Provider Business Practice Location Address Details
Address
1931 Center St
City
Berkeley
State
California
Zip
94704-1105
Phone Number
408-613-0770
Fax Number
510-666-0987
person
Provider Business Mailing Address Details
Address
1931 Center St
City
Berkeley
State
California
Zip
94704-1105
Phone Number
408-613-0770
Fax Number
510-666-0987
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
()
Definition
Definition to come...
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