| Doctor Name: | KELLY RENEE CASSELL |
| NPI Number: | 1255723912 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LPC |
| License Number: | 0701006065 |
| Business Practice Address: | 540 W Main St Wytheville, VA - 243822209 |
| Business Phone Number: | 2762233291 |
| Business Fax Number: | 2762233249 |
| Mailing Address: | 7054 W Blue Grass Trl, CERES |
| State: | VA |
| Postal Code: | 243183456 |
| Phone Number: | 2766131730 |
| Fax Number: | |
| NPI Enumeration Date: | 03/04/2015 |
| NPI Last Update Date: | 03/04/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 0701006065 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |