Provider Demographics
NPI:1710275961
Name:HAMLIN, KELLY LORENE (LPCC)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:LORENE
Last Name:HAMLIN
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MRS
Other - First Name:KELLY
Other - Middle Name:LORENE HAMLIN
Other - Last Name:KRUPP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPCC
Mailing Address - Street 1:2600 YALE BLVD SE
Mailing Address - Street 2:UNMH - ASAP
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4217
Mailing Address - Country:US
Mailing Address - Phone:505-994-7999
Mailing Address - Fax:505-243-0366
Practice Address - Street 1:2600 YALE BLVD SE
Practice Address - Street 2:UNMH - ASAP
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4217
Practice Address - Country:US
Practice Address - Phone:505-994-7999
Practice Address - Fax:505-243-0366
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0153261101YP2500X
OHE0003598101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional