MEDICARE: KELSEY KARR THERAPY, LLC

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	1041C0700X	Clinical Social Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972194728
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KELSEY KARR THERAPY, LLC

Provider Business Mailing Address
First Line	:	3161 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3144
Country	:	US
Telephone Number	:	702-305-5490
Fax Number	:	725-203-2976

Provider Business Practice Location Address
First Line	:	3161 E WARM SPRINGS RD STE 300
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89120-3144
Country	:	US
Telephone Number	:	702-305-5490
Fax Number	:

Authorized Official
Title or Position	:	LCSW, OWNER
Name	:	KELSEY MARIE KARR
Credential	:	LCSW
Telephone Number	:	702-305-5490

Provider Enumeration Date	:	02/02/2021
Last Update Date	:	02/02/2021

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