Brian Lee Kelley, LCPC
Counselor, Professional in Evergreen Park, IL. Individual provider (NPI-1).
NPI number1003191990
StatusActive
Last updated in NPPESJan 24, 2021
Details
- NPI
- 1003191990
- Entity type
- Individual (NPI-1)
- Name
- Mr. Brian Lee Kelley
- Credential
- LCPC
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Oct 11, 2011
- Certification date
- Jan 24, 2021
- Last updated
- Jan 24, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YP2500X | Counselor, Professional | 180007807 | IL | Yes |
Practice location
3317 W 95th StEvergreen Park, IL 60805-2243
Phone 708-529-3011
Mailing address
10s141 Suffield DrDowners Grove, IL 60516-5184
Phone 773-316-8697
Other practice locations
16547 Oak Park Ave
Tinley Park, IL 60477-1752
Tinley Park, IL 60477-1752
Phone 708-633-9003
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