Provider Demographics
NPI:1700385226
Name:BRITNI KELLEY COUNSELING, PLLC
Entity Type:Organization
Organization Name:BRITNI KELLEY COUNSELING, PLLC
Other - Org Name:SAGE LEAF WELLNESS, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRITNI
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:KELLEY
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LMFT
Authorized Official - Phone:763-528-3121
Mailing Address - Street 1:821 RAYMOND AVE STE 270
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1509
Mailing Address - Country:US
Mailing Address - Phone:612-293-8019
Mailing Address - Fax:
Practice Address - Street 1:821 RAYMOND AVE STE 270
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55114-1509
Practice Address - Country:US
Practice Address - Phone:612-293-8019
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-10
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3453106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty