Individual
STEPHANIE KELLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2604 N 109TH PLZ APT 302, OMAHA, NE 68164-3861
(254) 317-3534
Mailing address
2604 N 109TH PLZ APT 302, OMAHA, NE 68164-3861
(254) 317-3534
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
5813
NE
1041C0700X
Clinical Social Worker
Primary
2124
NE
Other
Enumeration date
06/08/2022
Last updated
06/08/2022
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