Healthcare Provider Details

I. General information

NPI: 1457267304
Provider Name (Legal Business Name): KELLENE HELSEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4255 N IN THE PINES TRL
FLAGSTAFF AZ
86001-1945
US

IV. Provider business mailing address

PO BOX 185
FLAGSTAFF AZ
86002-0185
US

V. Phone/Fax

Practice location:
  • Phone: 928-814-3353
  • Fax:
Mailing address:
  • Phone: 928-814-3353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number24282
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: