Individual provider · Type 1 NPI

Kelly Waggoner, LPCC

Mental Health Counselor · Lilburn, GA

NPI number 1730501511 Active

Practice location

5165 Bowers Brook Dr SW
Lilburn, GA 30047-5172

Call (505) 695-1613 Map

Other practice locations

  • 11005 Spain Rd NE Ste 21, Albuquerque, NM 87111-1871 · (505) 695-1613

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XCCHM0207621 (NM)

Mental Health Counselor: Definition to come...

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About NPI 1730501511

Kelly Waggoner, LPCC's National Provider Identifier is 1730501511, issued on Jan 13, 2014. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Lilburn, GA. The record was last updated on Jul 20, 2020.