MEDICARE: KELLEY ANN HEBERT MA, LPCA

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
1	101YM0800X	Mental Health Counselor	98791	TX

General Provider Information

NPI Number	:	1649063389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLEY ANN HEBERT MA, LPCA

Provider Business Mailing Address
First Line	:	5004 FOUNTAINWOOD CIR
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78633-1913
Country	:	US
Telephone Number	:	925-321-2049
Fax Number	:	925-321-2049

Provider Business Practice Location Address
First Line	:	5524 BEE CAVES RD STE B1
Second Line	:
City	:	WEST LAKE HILLS
State	:	TX
Zip	:	78746-5248
Country	:	US
Telephone Number	:	925-321-2049
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/26/2025
Last Update Date	:	05/26/2025

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