Kelley, Timothy Eugene

Kelley, Timothy Eugene is an sole proprietor health care provider with primary practice located at 313 West Third Street, Suite 204 , La Junta CO 81050. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Kelley, Timothy Eugene can be contacted via phone (719) 469-0799.

Contact Information

Primary practice address
313 West Third Street, Suite 204 La Junta CO 81050
Phone: (719) 469-0799
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 3479 Colorado
Behavioral Health & Social Service Providers / Professional 101YP2500X 3479 Colorado

Profile Details

NPI number 1710223698
LBN Legal business name Kelley, Timothy Eugene
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 20th, 2012
Last updated Dec 20th, 2012 - about 12 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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