KELLY KETELAAR LPC
NPI 1851049621
Counselor - Professional in Manhattan, IL
Active since March 11, 2022
About Kelly Ketelaar Lpc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KELLY KETELAAR LPC (NPI 1851049621) is an individual professional provider in Manhattan, Illinois, licensed in Illinois (178.016090) and active in the NPI registry since March 2022.
NPPES Registry Identity
NPI1851049621
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameKELLY KETELAARCredential: LPC
Location Address25447 ELAM DRManhattan, IL 60442-6219
Mailing Address25447 Elam DrManhattan, IL 60442-6219 · (815) 530-5092
Phone(815) 530-5092
Sole ProprietorYes
Enumeration DateMarch 11, 2022
NPPES CertifiedMarch 11, 2022
✔ NPI 1851049621 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in IL · 178.016090
25447 ELAM DR, Manhattan, IL 60442
Group Practice 1
Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1851049621, enumerated as an "individual" on March 11, 2022.
The provider is located at 25447 ELAM DR MANHATTAN, IL 60442 and the phone number is (815) 530-5092.
Counselor with taxonomy code 101YP2500X and a focus in Professional.
