Organization
KELLY THOMACK COUNSELING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY THOMACK LPCC (OWNER)
(920) 418-1150
Entity
Organization
Contact information
Practice address
5601 W GRANDE MARKET DR STE M, APPLETON, WI 54913-8506
(920) 215-1105
(937) 606-3077
Mailing address
5601 W GRANDE MARKET DR STE M, APPLETON, WI 54913-8506
(920) 418-1150
(937) 606-3077
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
06/17/2022
Last updated
06/17/2022
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