Provider Demographics
NPI:1346620440
Name:CAUSEY, KELLY LOU BROOKS (MSW, LCSW-A)
Entity type:Individual
Prefix:MS
First Name:KELLY LOU
Middle Name:BROOKS
Last Name:CAUSEY
Suffix:
Gender:F
Credentials:MSW, LCSW-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4325 HALLIWELL DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27606-6404
Mailing Address - Country:US
Mailing Address - Phone:919-607-3184
Mailing Address - Fax:
Practice Address - Street 1:1104 N GREENSBORO ST
Practice Address - Street 2:APT 13
Practice Address - City:CARRBORO
Practice Address - State:NC
Practice Address - Zip Code:27510-1364
Practice Address - Country:US
Practice Address - Phone:919-607-3184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0095821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical