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NPI 1073050548

NPI 1073050548 : KELCCEY MANCHESTER LPC : PLEASANTON, KS

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General NPI Number Information
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    NPI Number           |    1073050548
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    Entity Type          |    Individual 
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    Provider Name        |    KELCCEY MANCHESTER LPC
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/23/2017
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    Last Update Date     |    05/30/2025
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Provider Practice Location Address
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    Address Line         |    505 W 15TH ST 
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    City                 |    PLEASANTON
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    State                |    KS
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    Zip                  |    66075-4095
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    Country              |    US
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    Telephone            |    913-352-8214
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    100 LAKEMARY DR 
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    City                 |    PAOLA
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    State                |    KS
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    Zip                  |    66071-1855
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YP2500X
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    Taxonomy Name        |    Professional Counselor
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    License Number       |    
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    License Number State |    
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