Provider Demographics
NPI:1518793256
Name:BARRERA, KELSEY (MS, LPC-ASSOCIATE)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:BARRERA
Suffix:
Gender:F
Credentials:MS, LPC-ASSOCIATE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6713 HEAVENS GATE DR
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78413-4507
Mailing Address - Country:US
Mailing Address - Phone:361-480-7064
Mailing Address - Fax:
Practice Address - Street 1:2606 HOSPITAL BLVD STE B
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-1804
Practice Address - Country:US
Practice Address - Phone:361-902-6100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-10
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89580101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional