Provider Demographics
NPI:1922394337
Name:PURSELLEY, KELLEY (MA, LLMHC)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:PURSELLEY
Suffix:
Gender:F
Credentials:MA, LLMHC
Other - Prefix:
Other - First Name:KELLEY
Other - Middle Name:
Other - Last Name:MCCAFFERTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA
Mailing Address - Street 1:7 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03060
Mailing Address - Country:US
Mailing Address - Phone:603-889-6147
Mailing Address - Fax:603-883-1568
Practice Address - Street 1:440 AMHURST ST
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03060
Practice Address - Country:US
Practice Address - Phone:603-889-6147
Practice Address - Fax:603-595-0758
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
NH1082101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor