Individual
SHELLY KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCAC
Contact information
Practice address
201 N ILLINOIS ST, INDIANAPOLIS, IN 46204-1904
(317) 610-3201
Mailing address
776 GRABER CT, COLUMBIA CITY, IN 46725-8448
(260) 388-2356
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
101YM0800X
Mental Health Counselor
—
—
Other
Enumeration date
06/27/2022
Last updated
06/27/2022
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