Individual
KELLI LONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
Mailing address
500 LIMIT ST, LEAVENWORTH, KS 66048-4435
(913) 682-5118
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
Primary
9392
KS
Other
Enumeration date
04/16/2015
Last updated
01/02/2024
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