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NPI Code Detail

MEDICARE: KELCEY KILLINGSWORTH PHD, LMHC, NCC

MEDICARE:   KELCEY  KILLINGSWORTH  PHD, LMHC, NCC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorMH 10486FL

General Provider Information

NPI Number : 1346474491
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELCEY KILLINGSWORTH PHD, LMHC, NCC
Provider Business Mailing Address
First Line : 1150 N 12TH AVE
Second Line :
City : PENSACOLA
State : FL
Zip : 32501-3308
Country : US
Telephone Number : 850-602-2411
Fax Number :
Provider Business Practice Location Address
First Line : 1150 N 12TH AVE
Second Line :
City : PENSACOLA
State : FL
Zip : 32501-3308
Country : US
Telephone Number : 850-602-2411
Fax Number : 850-469-1081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/05/2009
Last Update Date : 03/29/2017

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Directions to “ KELCEY KILLINGSWORTH PHD, LMHC, NCC” Practice Location

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