# MIKE B KELLY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1902967227
- **Gender:** Man
- **Credential:** M.A., LIMHP, PLADC,

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | P-939 | NE | — |
| 101YM0800X | Mental Health Counselor | 2718 | NE | — |
| 101YM0800X | Mental Health Counselor | 928 | NE | Yes |
| 101YP2500X | Professional Counselor | 1446 | NE | — |

## Other

- **Enumeration date:** 12/12/2006
- **Last updated:** 12/04/2019