Provider Demographics
NPI:1831312305
Name:WELVAERT, KELLI RENAE (PLMHP)
Entity Type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:RENAE
Last Name:WELVAERT
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 616
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:NE
Mailing Address - Zip Code:68005-0616
Mailing Address - Country:US
Mailing Address - Phone:402-292-7722
Mailing Address - Fax:
Practice Address - Street 1:2101 SO 42 ST
Practice Address - Street 2:HEARTLAND FAMILY SERVICE
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105
Practice Address - Country:US
Practice Address - Phone:402-552-7416
Practice Address - Fax:402-552-7497
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE7239101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health