Healthcare Provider Details

I. General information

NPI: 1316675143
Provider Name (Legal Business Name): KELSEY WESTWOOD MA, LADC, LPCC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1385 MENDOTA HEIGHTS RD STE 200
MENDOTA HEIGHTS MN
55120-1289
US

IV. Provider business mailing address

1385 MENDOTA HEIGHTS RD STE 200
MENDOTA HEIGHTS MN
55120-1289
US

V. Phone/Fax

Practice location:
  • Phone: 651-379-9800
  • Fax:
Mailing address:
  • Phone: 651-379-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3458
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: