Provider Demographics
NPI:1134258692
Name:KELCH, TAMMY GENE (LMHP, LADC, CPC)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:GENE
Last Name:KELCH
Suffix:
Gender:F
Credentials:LMHP, LADC, CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 W. 9TH STREET
Mailing Address - Street 2:P.O. BOX 264
Mailing Address - City:SYRACUSE
Mailing Address - State:NE
Mailing Address - Zip Code:68446-0264
Mailing Address - Country:US
Mailing Address - Phone:402-890-9957
Mailing Address - Fax:402-269-3145
Practice Address - Street 1:600 N. COTNER BLVD
Practice Address - Street 2:SUITE 106
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68505-0019
Practice Address - Country:US
Practice Address - Phone:402-890-9957
Practice Address - Fax:402-269-3145
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE638101YA0400X
NE2971101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)