NPIMap

Organization Active NPI

Kelly Harrison Counseling PLLC

  • Mental Health Counselor
  • Raleigh, NC
National Provider Identifier
1568929503
Registry record updated Jun 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
KELLY HARRISON COUNSELING PLLC
Practice address
4030 Wake Forest Rd Ste 206
Raleigh, NC 27609-6800
Phone
(919) 713-0260
Fax
(919) 591-0161
NPI assigned
Feb 26, 2019
Last updated
Jun 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Kelly Lynn Harrison, MA, LMFT, LPCNPI 1033458500
Title
Owner
Phone
(919) 713-0260

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

4030 Wake Forest Rd Ste 206
Raleigh, NC 27609-6800

Mailing address

4030 Wake Forest Rd Ste 206
Raleigh, NC 27609-6800
Phone (919) 713-0260

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250923003827 NC Part B Supplier - Clinic/Group Practice 0648775429 Receives reassigned benefits from 2 practitioners
Practice locations: Raleigh, NC

National Provider Directory

National Provider Directory

Locations

3200 Wake Forest Rd
Ste 204
Raleigh, NC 27609
Phone (919) 713-0260

4030 Wake Forest Rd
Ste 206
Raleigh, NC 27609
Phone (919) 713-0260

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1551139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749600000000",
    "number": "1568929503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD STE 206",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096800",
            "telephone_number": "919-713-0260",
            "fax_number": "919-591-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4030 WAKE FOREST RD STE 206",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276096800",
            "telephone_number": "919-713-0260",
            "fax_number": "919-591-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY HARRISON COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-26",
        "last_updated": "2025-06-11",
        "certification_date": "2025-06-11",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-713-0260",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LMFT, LPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.