Provider Demographics
NPI:1114432879
Name:PERRON, KELLY A (MS, LPC, LCMHC, AADC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:A
Last Name:PERRON
Suffix:
Gender:F
Credentials:MS, LPC, LCMHC, AADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:885 GOLD HILL RD # 1040
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29708-7946
Mailing Address - Country:US
Mailing Address - Phone:803-993-8424
Mailing Address - Fax:
Practice Address - Street 1:885 GOLD HILL RD # 1040
Practice Address - Street 2:
Practice Address - City:FORT MILL
Practice Address - State:SC
Practice Address - Zip Code:29708-7946
Practice Address - Country:US
Practice Address - Phone:803-993-8424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-04
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)