Provider Demographics
NPI:1467216507
Name:JAMES, KELSHA RAYANN (LPC)
Entity Type:Individual
Prefix:
First Name:KELSHA
Middle Name:RAYANN
Last Name:JAMES
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 1:2001 LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-7718
Mailing Address - Country:US
Mailing Address - Phone:816-518-6272
Mailing Address - Fax:
Practice Address - Street 1:2001 LIBERTY DR
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-7718
Practice Address - Country:US
Practice Address - Phone:816-518-6272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04590101YP2500X
TX90674101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional