Kelley, Michelle

Kelley, Michelle is an sole proprietor health care provider with primary practice located at 4455 E 56Th St , Davenport IA 52807-2995. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Kelley, Michelle can be contacted via phone (563) 549-0209.

Contact Information

Primary practice address
4455 E 56Th St Davenport IA 52807-2995
Phone: (563) 549-0209
Fax: (563) 888-1060
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 00768 Iowa

Profile Details

NPI number 1467593962
LBN Legal business name Kelley, Michelle
Credentials L.M.H.C., L.C.P.C.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 9th, 2007
Last updated Jul 14th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467593962 NPPES
Iowa MEDICAID 0074526

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