Organization · NPI-2

Brandy Kelley Counseling, PLLC

Clinic/Center, Adult Mental Health · Springfield, IL

NPI number1073360574
StatusActive
Last updated in NPPESMay 2, 2024

Details

NPI
1073360574
Entity type
Organization (NPI-2)
Legal business name
Brandy Kelley Counseling, PLLC
Organization subpart
No
Enumeration date
May 2, 2024
Certification date
May 2, 2024
Last updated
May 2, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM0850X Clinic/Center, Adult Mental Health––Yes

Practice location

2501 Chatham Rd Ste N
Springfield, IL 62704-4188

Phone 217-383-0964

Mailing address

2501 Chatham Rd Ste N
Springfield, IL 62704-4188

Authorized official

Brandy Kelley
Owner
7086742199

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