# KELLEY COSTELLO, LMFT, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kelley Costello, LMFT, Inc.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164029344
- **Authorized official:** MS. KELLEY ANNE COSTELLO LMFT (OWNER/PRESIDENT)
- **Authorized official phone:** (774) 322-1306

## Contact information

- **Practice address:** 10 S MAIN ST STE 207, ATTLEBORO, MA 02703-2920
- **Practice address phone:** (774) 322-1306
- **Mailing address:** 10 S MAIN ST STE 207, ATTLEBORO, MA 02703-2920
- **Mailing address phone:** (774) 322-1306

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | — |
| 101YM0800X | Mental Health Counselor | — | — | — |
| 106H00000X | Marriage & Family Therapist | — | NULL | Yes |
| 106H00000X | Marriage & Family Therapist | — | — | Yes |

## Other

- **Enumeration date:** 10/01/2020
- **Last updated:** 10/01/2020