Provider Demographics
NPI:1154069367
Name:LAMMERS, KELLEY ANNE (LPC)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:ANNE
Last Name:LAMMERS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 717
Mailing Address - Street 2:
Mailing Address - City:MANILA
Mailing Address - State:AR
Mailing Address - Zip Code:72442-0717
Mailing Address - Country:US
Mailing Address - Phone:870-570-0358
Mailing Address - Fax:870-570-0359
Practice Address - Street 1:920 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:MANILA
Practice Address - State:AR
Practice Address - Zip Code:72442-8416
Practice Address - Country:US
Practice Address - Phone:870-570-0358
Practice Address - Fax:870-570-0359
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional