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Organization
KELLY ALTIC LISW-S COUNSELING LLC
Active
Organization
KELLY ALTIC LISW-S COUNSELING LLC
Active
Other names
Healthy Self Counseling
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ALTIC LISW-S (OWNER)
(614) 974-9808
Entity
Organization
Contact information
Practice address
670 MERIDIAN WAY STE 225, WESTERVILLE, OH 43082-2304
(614) 974-9808
Mailing address
670 MERIDIAN WAY STE 225, WESTERVILLE, OH 43082-2304
(614) 974-9808
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0324160
—
OH
Enumeration date
04/14/2021
Last updated
04/14/2021
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