Provider Demographics
NPI:1033821277
Name:MONCEAUX, KELSEY MICHELLE (BA)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:MICHELLE
Last Name:MONCEAUX
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:MICHELLE
Other - Last Name:STROTHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4702 BENTONITE BLVD
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-9805
Mailing Address - Country:US
Mailing Address - Phone:409-988-2463
Mailing Address - Fax:
Practice Address - Street 1:4702 BENTONITE BLVD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-9805
Practice Address - Country:US
Practice Address - Phone:409-988-2463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-20
Last Update Date:2022-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator