Individual
NANCY L KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC-C, LADC
Contact information
Practice address
329 BATH RD, BRUNSWICK, ME 04011-2673
(800) 434-3000
Mailing address
329 BATH RD, BRUNSWICK, ME 04011-2673
(800) 434-3000
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LC2646
ME
101YP2500X
Professional Counselor
XL4613
ME
Other
Enumeration date
07/27/2010
Last updated
01/08/2016
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