Provider Demographics
NPI:1841855400
Name:ANDERSON, KELSEY ANN (LMFT, LPC)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:ANN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 WILLIAMS RD
Mailing Address - Street 2:
Mailing Address - City:DRY PRONG
Mailing Address - State:LA
Mailing Address - Zip Code:71423-4052
Mailing Address - Country:US
Mailing Address - Phone:318-625-2024
Mailing Address - Fax:
Practice Address - Street 1:710 VERSAILLES BLVD
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71303-2351
Practice Address - Country:US
Practice Address - Phone:318-787-6749
Practice Address - Fax:318-787-6804
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMFT1419106H00000X
171M00000X
LA8369101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator