Provider Demographics
NPI:1457113748
Name:KELLERMAN'S COUNSELING, LLC
Entity Type:Organization
Organization Name:KELLERMAN'S COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KELLERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:814-795-6310
Mailing Address - Street 1:1924 KEYSTONE DR # 1025
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-7702
Mailing Address - Country:US
Mailing Address - Phone:814-795-6310
Mailing Address - Fax:
Practice Address - Street 1:18700 REYNOLDS RD
Practice Address - Street 2:
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-3665
Practice Address - Country:US
Practice Address - Phone:814-795-6310
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health