Individual
KELLIE JOHANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
835 HANOVER ST STE 305, MANCHESTER, NH 03104-5401
(603) 770-6783
Mailing address
PO BOX 292, EXETER, NH 03833-0292
(603) 770-6783
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
4916
NH
Other
Enumeration date
11/19/2019
Last updated
03/04/2025
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