Individual
KELLI SHANNON NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
675 S ARROYO PKWY STE 420, PASADENA, CA 91105-3215
(925) 282-1778
Mailing address
PO BOX 448, MONROVIA, CA 91017-0448
(626) 646-4877
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15081
CA
101YM0800X
Mental Health Counselor
21583
CA
101YP2500X
Professional Counselor
Primary
21583
CA
Other
Enumeration date
12/14/2024
Last updated
03/05/2026
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