MARK RYAN KELLY LPC, LCDC - NPI 1366804742

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YP2500X and a focus in Professional.

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About Mark Ryan Kelly Lpc, Lcdc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARK RYAN KELLY LPC, LCDC (NPI 1366804742) is an individual professional provider in Victoria, Texas, licensed in Texas (82018) and active in the NPI registry since March 2016.

NPPES Registry Identity

NPI1366804742

Entity TypeIndividualMale

Primary Taxonomy101YP2500X

Provider Legal NameMARK RYAN KELLYCredential: LPC, LCDC

Location Address802 E CRESTWOOD DRVictoria, TX 77901-3309

Mailing Address802 E Crestwood DrVictoria, TX 77901-3309 · (361) 576-4673

Phone(361) 576-4673

Sole ProprietorNo

Enumeration DateMarch 24, 2016

Last NPPES UpdateJanuary 21, 20264 updates tracked since enumeration

NPPES CertifiedJanuary 21, 2026

✔ NPI 1366804742 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in TX · 82018

802 E CRESTWOOD DR, Victoria, TX 77901

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.Insurance ›

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STEPHANIE ANN BASSANO LCDC, CCJP, DOT/SAP

Counselor (Addiction (Substance Use Disorder))