Individual
M LUCILLE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
421 POPLAR RD, CENTERTON, AR 72719-7944
(248) 701-9889
Mailing address
421 POPLAR RD, CENTERTON, AR 72719-7944
(248) 701-9889
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
P2511020
AR
101YP2500X
Professional Counselor
Primary
6401000490
MI
Other
Enumeration date
07/24/2023
Last updated
04/24/2026
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