Healthcare Provider Details

I. General information

NPI: 1326916263
Provider Name (Legal Business Name): JACOBIE DENISE KELSEY
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

AAMU. DEPT. OF SOCIAL WORK SUITE 130, BUCHANAN HALL
NORMAL AL
35762
US

IV. Provider business mailing address

AAMU. DEPT. OF SOCIAL WORK SUITE 130, BUCHANAN HALL
NORMAL AL
35762
US

V. Phone/Fax

Practice location:
  • Phone: 256-937-8263
  • Fax:
Mailing address:
  • Phone: 256-937-8263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: