Provider Demographics
NPI:1205916715
Name:NORMAN, KELLEY (LMHC)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:
Last Name:NORMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KELLEY
Other - Middle Name:
Other - Last Name:NORMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:640 S MISSION ST
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801-3050
Mailing Address - Country:US
Mailing Address - Phone:509-662-6761
Mailing Address - Fax:
Practice Address - Street 1:640 S MISSION ST
Practice Address - Street 2:
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-3050
Practice Address - Country:US
Practice Address - Phone:509-662-6761
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5790101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health