Individual
MR. KELLEY J. LACKEY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS-LPC
Contact information
Practice address
1307 RURAL ST, EMPORIA, KS 66801-5541
(620) 481-9403
Mailing address
PO BOX 145, EMPORIA, KS 66801-0145
(620) 208-6880
(620) 342-1021
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LPC3453
KS
101YP2500X
Professional Counselor
Primary
3453
KS
Other
Enumeration date
07/22/2019
Last updated
12/02/2022
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