Organization
KECIA BLAKELY, MSP, LMHC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KECIA MARIE BLAKELY LMHC (OWNER)
(574) 800-9681
Entity
Organization
Contact information
Practice address
52189 SCOTT ST, SOUTH BEND, IN 46637
(574) 208-3359
Mailing address
52189 SCOTT ST, SOUTH BEND, IN 46637-2952
(574) 800-9681
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
07/26/2023
Last updated
09/03/2024
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