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Organization

KETELHUT COUNSELING LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SHELLY LYNN KETELHUT LPC NCC CSAC (OWNER/THERAPIST)
(920) 948-9787
Entity
Organization

Contact information

Practice address
1936B ALGOMA BLVD, OSHKOSH, WI 54901-2104
(920) 948-9787
(920) 231-1755
Mailing address
1936B ALGOMA BLVD, OSHKOSH, WI 54901-2104
(920) 948-9787
(920) 231-1755

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
15724132
WI
251S00000X
Community/Behavioral Health Agency
Primary
4498125
WI

Other

Enumeration date
05/08/2014
Last updated
05/08/2014
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