Provider Demographics
NPI:1427624097
Name:ELMY, KIRBY
Entity type:Individual
Prefix:
First Name:KIRBY
Middle Name:
Last Name:ELMY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KIRBY
Other - Middle Name:
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:196 KEOWEE TRL
Mailing Address - Street 2:
Mailing Address - City:CLEMSON
Mailing Address - State:SC
Mailing Address - Zip Code:29631-1410
Mailing Address - Country:US
Mailing Address - Phone:662-386-6360
Mailing Address - Fax:
Practice Address - Street 1:196 KEOWEE TRL
Practice Address - Street 2:
Practice Address - City:CLEMSON
Practice Address - State:SC
Practice Address - Zip Code:29631-1410
Practice Address - Country:US
Practice Address - Phone:864-633-7937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-03
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional