Individual
KELLY LEUTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
101 S LOCUST ST, CENTRALIA, IL 62801-3506
(618) 533-1391
Mailing address
PO BOX 201, SALEM, IL 62881-0201
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
180.009169
IL
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
07/08/2011
Last updated
01/02/2026
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