Healthcare Provider Details

I. General information

NPI: 1952731127
Provider Name (Legal Business Name): KELLY KATHLEEN KAZSIMER MSCP, LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 11/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3402 WASHINGTON RD SUITE 304
MC MURRAY PA
15317-2964
US

IV. Provider business mailing address

100 NORTH POINTE CIRCLE SUITE 306
SEVEN FIELDS PA
16046
US

V. Phone/Fax

Practice location:
  • Phone: 724-941-5363
  • Fax:
Mailing address:
  • Phone: 724-772-4848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC007214
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: