Individual
MS. KELLY J KING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
5600 S 59TH ST STE 104, LINCOLN, NE 68516-2387
(402) 484-0595
(402) 484-6306
Mailing address
5600 S 59TH ST STE 104, LINCOLN, NE 68516-2387
(402) 484-0595
(402) 484-6306
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
967
NE
101YM0800X
Mental Health Counselor
Primary
4152
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
96118
BCBS
NE
Enumeration date
09/25/2009
Last updated
03/15/2013
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