Individual
KELLI ANN BRUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
530 NW 3RD ST STE C, NEWPORT, OR 97365-3646
(541) 234-3522
(855) 702-3711
Mailing address
356 NW 57TH ST, NEWPORT, OR 97365-1196
(541) 961-4124
(855) 702-3711
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
L3967
OR
1041C0700X
Clinical Social Worker
Primary
L3967
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500631621
—
OR
Enumeration date
10/29/2010
Last updated
09/28/2023
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