Kelly Sanders Dusek, LPC, LCMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

19794 Issued in NC

Practice address

15812 Walnut Hill Dr
Charlotte, NC 28278-5010

Phone

(803) 542-9680

NPI assigned

May 8, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• The Resilient Bloom LLC

  • Mental Health Counselor
  • Fort Mill, SC
  • NPI 1669227500
  NPD Authorized official

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

{
    "created_epoch": "1557273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1952966681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15812 WALNUT HILL DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282785010",
            "telephone_number": "704-641-3824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15812 WALNUT HILL DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282785010",
            "telephone_number": "803-542-9680"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Stone Village Dr Ste D",
            "address_purpose": "LOCATION",
            "city": "Fort Mill",
            "state": "SC",
            "postal_code": "297086489",
            "country_code": "US",
            "telephone_number": "803-542-9680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUSEK",
        "first_name": "KELLY",
        "middle_name": "SANDERS",
        "credential": "LPC, LCMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-08",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "SC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "",
            "desc": "Counselor, School",
            "state": "NC",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "SC",
            "license": "7006",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "19794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan T Durrette, OT
• Lesslie Marquez Durst, P.A.-C
• Monique Duru
• Ashli Duryea
• Adrian Cristian Dusa, M.D.
• Attallah Dutes
• Jarred Ryan Dutka, CCC-SLP
• Manikankana Dutta, PT, DPT
• Carolyn Dutton
• Diane Szaflarski Dutton, D.O

• Mental Health Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.