Provider Demographics
NPI:1962264721
Name:SOMELIANA-LAUER, KELSEY NOELLE (LCMHCA)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:NOELLE
Last Name:SOMELIANA-LAUER
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2710 S 17TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-6678
Mailing Address - Country:US
Mailing Address - Phone:910-548-4280
Mailing Address - Fax:
Practice Address - Street 1:704 CROMWELL DR STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5894
Practice Address - Country:US
Practice Address - Phone:252-220-0420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19650101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health