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Individual

MR. BART WILLIAM KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
1978 BABCOCK RD, SAN ANTONIO, TX 78229-4512
(210) 710-4915
(210) 822-1790
Mailing address
4827 E BEVERLY MAE DR, SAN ANTONIO, TX 78229-4935
(210) 710-4915
(210) 822-1790

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3951
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6431LC
BLUE CROSS/ BLUE SHIELD
TX
Enumeration date
08/31/2006
Last updated
07/09/2007
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