Provider Demographics
NPI:1700622974
Name:DAY, KELLY ANN (LMHC, NCC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:DAY
Suffix:
Gender:F
Credentials:LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 PIXY CT
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-3197
Mailing Address - Country:US
Mailing Address - Phone:317-918-3195
Mailing Address - Fax:
Practice Address - Street 1:216 PIXY CT
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-3197
Practice Address - Country:US
Practice Address - Phone:317-918-3195
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39004972A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health