Provider Demographics
NPI:1942614318
Name:URTON, KELLI (PLMHP)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:URTON
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 1:2302 8TH AVE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:PLATTSMOUTH
Mailing Address - State:NE
Mailing Address - Zip Code:68048-2365
Mailing Address - Country:US
Mailing Address - Phone:402-296-0531
Mailing Address - Fax:402-296-0562
Practice Address - Street 1:2302 8TH AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:PLATTSMOUTH
Practice Address - State:NE
Practice Address - Zip Code:68048-2365
Practice Address - Country:US
Practice Address - Phone:402-296-0531
Practice Address - Fax:402-296-0562
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-13
Last Update Date:2014-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE10275101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health