Individual
BETHANY A KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED, LPA
Contact information
Practice address
6500 GLENRIDGE PARK PL STE 3, LOUISVILLE, KY 40222-3450
(502) 614-7600
Mailing address
591 BEECH GROVE RD, SHEPHERDSVILLE, KY 40165-6483
(502) 468-2123
Taxonomy
Speciality
Code
Description
License number
State
103TC1900X
Counseling Psychologist
Primary
288702
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
288702
LICENSING NUMBER (LPA)
KY
Enumeration date
11/11/2021
Last updated
04/18/2024
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