Individual
MARK KELSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 522-0140
(208) 524-7335
Mailing address
2267 TETON PLZ, IDAHO FALLS, ID 83404-6486
(208) 524-4953
(208) 524-7335
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LCSW-37136
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346368198
—
ID
Enumeration date
04/20/2011
Last updated
11/22/2023
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