Provider Demographics
NPI:1033706775
Name:LORD, KELLEY ANN (BA)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:ANN
Last Name:LORD
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1037 COMPASS CIR
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-2788
Mailing Address - Country:US
Mailing Address - Phone:724-834-1144
Mailing Address - Fax:
Practice Address - Street 1:1037 COMPASS CIR
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-2788
Practice Address - Country:US
Practice Address - Phone:724-834-1144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)