Provider Demographics
NPI:1477954758
Name:KELLY, DANIELLE (MSW, LCSW, LCAS)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:
Last Name:KELLY
Suffix:
Gender:F
Credentials:MSW, LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 PROVIDENCE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-6200
Mailing Address - Country:US
Mailing Address - Phone:199-260-5841
Mailing Address - Fax:
Practice Address - Street 1:141 PROVIDENCE RD STE 130
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27514-6200
Practice Address - Country:US
Practice Address - Phone:199-260-5841
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-05
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0115781041C0700X
NCLCAS-23859101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)