Provider Demographics
NPI:1932510997
Name:KELSEY, STEVEN MAURICE (PHD; MED, LPCC)
Entity Type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:MAURICE
Last Name:KELSEY
Suffix:
Gender:M
Credentials:PHD; MED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4936 HAZELWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40214-1254
Mailing Address - Country:US
Mailing Address - Phone:502-664-7405
Mailing Address - Fax:
Practice Address - Street 1:4936 HAZELWOOD AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40214-1254
Practice Address - Country:US
Practice Address - Phone:502-664-7405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-1726101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health