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:
Health care specialties
| Specialty | Code | License # | 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 5 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467593962 | NPPES |
| Iowa | MEDICAID | 0074526 |
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