Provider Demographics
NPI:1932535440
Name:KELSO, KIRSTEN GRAVES (LMFT)
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:GRAVES
Last Name:KELSO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1138 JEFFERSON ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-5246
Mailing Address - Country:US
Mailing Address - Phone:541-286-3039
Mailing Address - Fax:541-683-5417
Practice Address - Street 1:227 W 13TH AVE STE 106
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3675
Practice Address - Country:US
Practice Address - Phone:541-286-3039
Practice Address - Fax:541-683-5417
Is Sole Proprietor?:No
Enumeration Date:2013-09-17
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor