Individual
PATRICIA V KELLEHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA,LCPC
Contact information
Practice address
159 WALDO AVE APT 2, BELFAST, ME 04915-6941
(207) 505-8561
Mailing address
159 WALDO AVE APT 2, BELFAST, ME 04915-6941
(207) 505-8561
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC2066
ME
101YP2500X
Professional Counselor
CC2066
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288710099
—
ME
Enumeration date
08/31/2007
Last updated
01/16/2024
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