Individual
MICHELLE RENEE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
35139 312TH RD, CEDAR VALE, KS 67024-9305
(620) 441-8856
Mailing address
35139 312TH RD, CEDAR VALE, KS 67024-9305
(620) 441-8856
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
T-LC
KS
101YP2500X
Professional Counselor
Primary
3616
KS
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3616
—
KS
Enumeration date
06/03/2020
Last updated
12/04/2024
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