Provider Demographics
NPI:1609323864
Name:LAMOTTE, KELLY (TLMHC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:LAMOTTE
Suffix:
Gender:F
Credentials:TLMHC
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:HEIKENS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:600 42ND ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50312-2701
Mailing Address - Country:US
Mailing Address - Phone:515-255-8399
Mailing Address - Fax:
Practice Address - Street 1:1609 N ANKENY BLVD STE 210
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-4159
Practice Address - Country:US
Practice Address - Phone:515-255-8399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-16185101Y00000X
IA084322101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor