Provider Demographics
NPI:1982181236
Name:LEAMING, KELLY L (LPC-INTERN, LCDC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:L
Last Name:LEAMING
Suffix:
Gender:F
Credentials:LPC-INTERN, LCDC
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:L
Other - Last Name:ENGELMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1103 WEST STAN SCHLUETER LOOP
Mailing Address - Street 2:BUILDING A SUITE 100
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1103 WEST STAN SCHLUETER LOOP
Practice Address - Street 2:BUILDING A SUITE 100
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549
Practice Address - Country:US
Practice Address - Phone:254-213-7847
Practice Address - Fax:254-312-2003
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13902101YP2500X
TX77029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional