Individual
BRAD KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW, LCAC
Contact information
Practice address
516 NATIONAL RD W, RICHMOND, IN 47374-4018
(765) 914-9116
(765) 488-0930
Mailing address
516 NATIONAL RD W, RICHMOND, IN 47374-4018
(765) 914-9116
(765) 488-0930
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
87000659A
IN
1041C0700X
Clinical Social Worker
Primary
34006759A
IN
Other
Enumeration date
11/06/2006
Last updated
11/24/2013
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