Provider Demographics
NPI:1477945566
Name:SCARBROUGH, KELSLAN LEE (LMHC, LPCC)
Entity Type:Individual
Prefix:MS
First Name:KELSLAN
Middle Name:LEE
Last Name:SCARBROUGH
Suffix:
Gender:F
Credentials:LMHC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:385 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-2729
Mailing Address - Country:US
Mailing Address - Phone:206-455-0622
Mailing Address - Fax:
Practice Address - Street 1:385 STEWART AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-2729
Practice Address - Country:US
Practice Address - Phone:206-455-0622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-26
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60749925101YM0800X
OHE.2102641101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0475787Medicaid