Individual
LLOYD THURSTON KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L..C.S.W.
Contact information
Practice address
2829 4TH AVE STE 150, LAKE CHARLES, LA 70601-7897
(337) 480-7800
(337) 474-4552
Mailing address
PO BOX 123977 DEPT 3977 150, DALLAS, TX 75312-0001
(337) 494-2772
(337) 494-2928
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1244
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1244
STATE LICENSE
LA
05
—
2509551
—
LA
Enumeration date
03/21/2006
Last updated
02/04/2022
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