Individual
JAMES KELLERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.H.P.
Contact information
Practice address
16342 N IL HWY 37, MT VERNON, IL 62864-0054
(618) 242-1510
(618) 242-0958
Mailing address
PO BOX 428, MOUNT VERNON, IL 62864-0054
(618) 242-1510
(618) 242-0958
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237254917005
—
IL
Enumeration date
11/08/2012
Last updated
11/08/2012
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