Provider Demographics
NPI:1245559350
Name:KELPIEN FEDERICO, ELAINE G (LPC)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:G
Last Name:KELPIEN FEDERICO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:132 RIVERSTONE TER
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-1703
Mailing Address - Country:US
Mailing Address - Phone:770-213-3615
Mailing Address - Fax:678-880-9813
Practice Address - Street 1:132 RIVERSTONE TER
Practice Address - Street 2:SUITE 102
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-1703
Practice Address - Country:US
Practice Address - Phone:770-213-3615
Practice Address - Fax:678-880-9813
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-28
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10235101YM0800X
GALPC007159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health