Provider Demographics
NPI:1760073191
Name:WILLIAMSON, KELSEY (LPCC)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3366 OAKDALE AVE N STE 315
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2967
Mailing Address - Country:US
Mailing Address - Phone:763-581-5372
Mailing Address - Fax:763-581-5371
Practice Address - Street 1:3366 OAKDALE AVE N STE 315
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2967
Practice Address - Country:US
Practice Address - Phone:763-581-5372
Practice Address - Fax:763-581-5371
Is Sole Proprietor?:No
Enumeration Date:2021-01-28
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2562101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional