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Individual

MS. BETHANY KELLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
4039 NICOLET AVE, LOS ANGELES, CA 90008-2217
(747) 403-0461
Mailing address
5500 YORK LN N, COLUMBUS, OH 43232-1565

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
108173
CA
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
Primary
108173
CA
1041C0700X
Clinical Social Worker
I.1500966
OH

Other

Enumeration date
07/17/2013
Last updated
12/17/2024
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