Provider Demographics
NPI:1891291688
Name:HARROLD, KELSEY KATHLEEN (PSYD, LMFT 123211)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:KATHLEEN
Last Name:HARROLD
Suffix:
Gender:F
Credentials:PSYD, LMFT 123211
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11600 WASHINGTON PL STE 102E
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5000
Mailing Address - Country:US
Mailing Address - Phone:310-625-5289
Mailing Address - Fax:
Practice Address - Street 1:11600 WASHINGTON PL STE 102E
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5000
Practice Address - Country:US
Practice Address - Phone:310-625-5289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA123211106H00000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist