Individual ProviderKishon KelleyCounselorBehavioral Health & Social Service ProvidersPractice Address1710 Highway 16 W, Griffin, GA 30223-7107(770) 229-3407PECOS EnrollmentBased on the most recent information from CMS, provider Kishon Kelley does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1255101622Provider TypeIndividualFull NameKelley, KishonGenderFemaleSole ProprietorNoEnumeration Date1/5/2024Last Updated1/8/2024Contact InformationPractice LocationPractice Address1710 Highway 16 W, Griffin, GA 30223-7107Phone(770) 229-3407FaxUnlisted FaxMailing LocationMailing Address1710 Highway 16 W, Griffin, GA 30223-7107Phone(770) 229-3407FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101Y00000XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseAPC008683Georgia