Provider Demographics
NPI:1457960213
Name:KELLEY SMITH COUNSELING LLC
Entity Type:Organization
Organization Name:KELLEY SMITH COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:614-359-2639
Mailing Address - Street 1:855 S WALL ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-1921
Mailing Address - Country:US
Mailing Address - Phone:614-706-0704
Mailing Address - Fax:614-972-6200
Practice Address - Street 1:855 S WALL ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43206-1921
Practice Address - Country:US
Practice Address - Phone:614-706-0704
Practice Address - Fax:614-972-6200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)