Provider Demographics
NPI:1558469841
Name:JAMES, KELLY ANN (LPC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:JAMES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9524 E 81ST ST
Mailing Address - Street 2:#1515
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-8032
Mailing Address - Country:US
Mailing Address - Phone:918-637-5533
Mailing Address - Fax:
Practice Address - Street 1:9524 E. 81ST STREET
Practice Address - Street 2:#1515
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133
Practice Address - Country:US
Practice Address - Phone:918-637-5533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3522101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional