Individual
MIKE B KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LIMHP, PLADC,
Contact information
Practice address
3810 CENTRAL AVE, KEARNEY, NE 68847-8134
(308) 237-5951
(308) 234-4018
Mailing address
3810 CENTRAL AVE, KEARNEY, NE 68847-8134
(083) 237-5951
(308) 234-4018
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
P-939
NE
101YM0800X
Mental Health Counselor
2718
NE
101YM0800X
Mental Health Counselor
Primary
928
NE
101YP2500X
Professional Counselor
1446
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025451701
—
NE
Enumeration date
12/12/2006
Last updated
12/04/2019
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