Provider Demographics
NPI:1225472673
Name:HARRIS, KELSEY KATHEEN (LPCC 2886)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:KATHEEN
Last Name:HARRIS
Suffix:
Gender:F
Credentials:LPCC 2886
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:KATHLEEN
Other - Last Name:TERRIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1140 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:PASO ROBLES
Mailing Address - State:CA
Mailing Address - Zip Code:93446-2532
Mailing Address - Country:US
Mailing Address - Phone:559-360-1547
Mailing Address - Fax:
Practice Address - Street 1:1140 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:PASO ROBLES
Practice Address - State:CA
Practice Address - Zip Code:93446
Practice Address - Country:US
Practice Address - Phone:559-360-1547
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-28
Last Update Date:2018-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC 2886101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional