Provider Demographics
NPI:1972257806
Name:VELEZ-KELSEY, BLAIR NOEL (MHCP)
Entity Type:Individual
Prefix:
First Name:BLAIR
Middle Name:NOEL
Last Name:VELEZ-KELSEY
Suffix:
Gender:F
Credentials:MHCP
Other - Prefix:
Other - First Name:NOELLE
Other - Middle Name:
Other - Last Name:KELSEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MHCP
Mailing Address - Street 1:424 S GRANITE ST
Mailing Address - Street 2:
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841-9541
Mailing Address - Country:US
Mailing Address - Phone:831-234-4234
Mailing Address - Fax:
Practice Address - Street 1:1009 KOALA DR
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-9247
Practice Address - Country:US
Practice Address - Phone:509-826-8444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-09
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG61223433101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor