Provider Demographics
NPI:1093447112
Name:ENGDORF, KELSEY (LPC ASSOCIATE)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:ENGDORF
Suffix:
Gender:F
Credentials:LPC ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5847 ETTRICK DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77035-4237
Mailing Address - Country:US
Mailing Address - Phone:713-822-3577
Mailing Address - Fax:
Practice Address - Street 1:5847 ETTRICK DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77035-4237
Practice Address - Country:US
Practice Address - Phone:713-822-3577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX83742101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health