Individual
KELSEY KATHLEEN PIERCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.COUN, LPC
Contact information
Practice address
110 S 19TH AVE, POCATELLO, ID 83201-3312
(208) 234-4722
(208) 234-2135
Mailing address
110 S 19TH AVE, POCATELLO, ID 83201-3312
(208) 234-4722
(208) 234-2135
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LPC-5977
ID
101YM0800X
Mental Health Counselor
Primary
LPC-5977
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-5977
STATE LPC NUMBER
ID
Enumeration date
07/30/2015
Last updated
07/30/2015
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