Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Blake Jillian Kellum, LCMHC

Individual provider Mental Health Counselor · NPI 1215699483

Blake Jillian Kellum, LCMHC is a Mental Health Counselor in Charlotte, North Carolina. Practices as a sole proprietor and works from 2 locations. Licensed in North Carolina.

Licensed in
NC
In the registry since
2021

Practice location Address checks out

2015 Ayrsley Town Blvd Ste 302-A
Charlotte, NC 28273-4067
Phone: (704) 350-5324
Fax: (980) 458-6037
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 919 N Main St, Mooresville, NC 28115-2355 — (704) 660-6854

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 16773 (NC)

Record details

NPI number1215699483
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCMHC
Sole proprietorYes
NPI enumeratedOctober 6, 2021
Last updated in NPPESJuly 31, 2026
Certification dateJuly 31, 2026

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