Provider Demographics
NPI:1003594185
Name:KELLEY, NATALIE CHRISTINE
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:CHRISTINE
Last Name:KELLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7214 EAGLE STONE LN
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-6649
Mailing Address - Country:US
Mailing Address - Phone:606-383-1253
Mailing Address - Fax:
Practice Address - Street 1:1906 COLLEGE HEIGHTS BLVD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-1000
Practice Address - Country:US
Practice Address - Phone:270-745-4204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-07
Last Update Date:2023-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health