Provider Demographics
NPI:1780616334
Name:HORNER, KELLY L (LPC)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:L
Last Name:HORNER
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 1:3 W MONUMENT SQ
Mailing Address - Street 2:SUITE 206
Mailing Address - City:LEWISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17044
Mailing Address - Country:US
Mailing Address - Phone:717-248-8197
Mailing Address - Fax:717-248-6449
Practice Address - Street 1:3 W MONUMENT SQ
Practice Address - Street 2:SUITE 206
Practice Address - City:LEWISTOWN
Practice Address - State:PA
Practice Address - Zip Code:17044-2188
Practice Address - Country:US
Practice Address - Phone:717-248-8197
Practice Address - Fax:717-248-6449
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003071101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional