Individual
KELLY MARIE MEAD
Active
Individual
KELLY MARIE MEAD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
8933A
NC
101YP2500X
Professional Counselor
Primary
LPC.0011766
CO
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
LPP.0001308
CO
Other
Enumeration date
05/29/2007
Last updated
02/28/2024
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