Provider Demographics
NPI:1780241984
Name:SCHULTHESS, KELLI RENE (LPC)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:RENE
Last Name:SCHULTHESS
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 1:301 WEGMAN RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19606-9719
Mailing Address - Country:US
Mailing Address - Phone:610-763-2318
Mailing Address - Fax:
Practice Address - Street 1:1800 N 12TH ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19604-1545
Practice Address - Country:US
Practice Address - Phone:610-816-5728
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011154101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional