Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Gordon-Wylie, LCSW-A

Individual provider Behavior Technician · NPI 1528502564

Kelly Gordon-Wylie, LCSW-A is a Behavior Technician in Wilmington, North Carolina. Practices as a sole proprietor and works from 2 locations. Licensed in North Carolina.

Licensed in
NC
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

615 Shipyard Blvd
Wilmington, NC 28412-6431
Phone: (910) 399-3755
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 309 Progress Dr, Burgaw, NC 28425-3280 — (910) 259-0668

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence P018674 (NC)
Behavior Technician Taxonomy 106S00000X

Record details

NPI number1528502564
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW-A
Sole proprietorYes
NPI enumeratedDecember 9, 2016
Last updated in NPPESSeptember 19, 2022
Certification dateSeptember 19, 2022

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