Provider Demographics
NPI:1558091066
Name:KELSEY, COURTENEY C (LMFT)
Entity Type:Individual
Prefix:
First Name:COURTENEY
Middle Name:C
Last Name:KELSEY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:COURTENEY
Other - Middle Name:C
Other - Last Name:COLVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8773 E CHRIS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-6407
Mailing Address - Country:US
Mailing Address - Phone:620-474-7784
Mailing Address - Fax:
Practice Address - Street 1:1600 N LORRAINE ST STE 202
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-5600
Practice Address - Country:US
Practice Address - Phone:620-663-7595
Practice Address - Fax:620-513-5098
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2870106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist