Kelly, Suzanne Autrey

Kelly, Suzanne Autrey is an sole proprietor health care provider with primary practice located at 110 W Elm St , Yadkinville NC 27055-1758. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Kelly, Suzanne Autrey can be contacted via phone (336) 677-3991.

Contact Information

Primary practice address
110 W Elm St Yadkinville NC 27055-1758
Phone: (336) 677-3991
Fax: (336) 677-1359
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X 60 North Carolina
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 1223 North Carolina
Behavioral Health & Social Service Providers / Professional 101YP2500X 1070 North Carolina

Profile Details

NPI number 1366420192
LBN Legal business name Kelly, Suzanne Autrey
Credentials LPC,LCAS,CEAP,LEAP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 3rd, 2006
Last updated Aug 27th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366420192 NPPES
North Carolina MEDICAID 6112226
North Carolina Other 1005H

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