Provider Demographics
NPI:1215710603
Name:HESS, KELLY C (LPC ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:C
Last Name:HESS
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9090 SKILLMAN ST STE 182A-251
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-8259
Mailing Address - Country:US
Mailing Address - Phone:214-506-8205
Mailing Address - Fax:214-506-8205
Practice Address - Street 1:9536 MILLRIDGE DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-6173
Practice Address - Country:US
Practice Address - Phone:214-506-8205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX92518101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional