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General NPI Number Information
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NPI Number | 1316662646
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Entity Type | Organization
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Legal Business Name | KELSEY WHALEN THERAPY, LLC
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Dates
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Enumeration Date | 10/10/2022
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Last Update Date | 11/02/2022
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Provider Practice Location Address
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Address Line | 444 MAIN ST STE 305
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City | LA CROSSE
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State | WI
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Zip | 54601-4099
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Country | US
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Telephone | 608-305-4903
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Fax | 608-218-3820
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Provider Business Mailing Address
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Address Line | 444 MAIN ST STE 305
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City | LA CROSSE
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State | WI
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Zip | 54601-4099
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Country | US
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Telephone | 608-305-4903
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Fax |
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Authorized Official
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Title or Position | OWNER, LMFT
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Name | KELSEY R WHALEN
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Credential | MA, LMFT
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Telephone | 608-305-4903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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