Healthcare Provider Details

I. General information

NPI: 1952455545
Provider Name (Legal Business Name): KELLY MARIE LAJOIE MBS, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KELLY MARIE CRAIG LPC

II. Dates (important events)

Enumeration Date: 01/22/2007
Last Update Date: 06/10/2025
Certification Date: 06/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3006 EUNICE AVE
SPRING HILL FL
34609-3421
US

IV. Provider business mailing address

320 W 37TH ST FL 5
NEW YORK NY
10018-4252
US

V. Phone/Fax

Practice location:
  • Phone: 580-317-6081
  • Fax: 580-298-6699
Mailing address:
  • Phone: 580-317-6081
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3790
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: