Provider Demographics
NPI:1598559569
Name:MCRORY, KELLYN RENAE (LPC)
Entity type:Individual
Prefix:MS
First Name:KELLYN
Middle Name:RENAE
Last Name:MCRORY
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8814 FARGO RD STE 125
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4628
Mailing Address - Country:US
Mailing Address - Phone:804-322-9955
Mailing Address - Fax:
Practice Address - Street 1:8814 FARGO RD STE 125
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-4628
Practice Address - Country:US
Practice Address - Phone:804-322-9955
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701014715101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health