Individual provider · Type 1 NPI
Kelly Wallis, LCPC
Mental Health Counselor · Virginia Beach, VA
NPI number
1659862050
Active
Practice location
1624 Laskin Rd Ste 736
Virginia Beach, VA 23451-7510
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mental Health Counselor | 101YM0800X | 0701012567 (VA) |
| Mental Health Counselor Primary | 101YM0800X | LC8679 (MD) |
Mental Health Counselor: Definition to come...
2 other providers at this address
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- Olga L. Russo, LPC-RMental Health Counselor Virginia Beach, VA NPI 1043117187
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- Karen Lee Buchanan, LCSWMental Health Counselor Virginia Beach, VA NPI 1053505842
About NPI 1659862050
Kelly Wallis, LCPC's National Provider Identifier is 1659862050, issued on May 22, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Virginia Beach, VA. The record was last updated on Oct 27, 2026.