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General NPI Number Information
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NPI Number | 1376427468
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Entity Type | Individual
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Provider Name | KELSY J KERRIGAN
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Gender | Female
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Dates
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Enumeration Date | 08/02/2025
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Last Update Date | 08/02/2025
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Provider Practice Location Address
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Address Line | 807 LIBERTY DR STE 106
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City | VERONA
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State | WI
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Zip | 53593-9160
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Country | US
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Telephone | 608-819-6394
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Fax |
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Provider Business Mailing Address
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Address Line | 148 E JEANETTE ST
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City | HERSCHER
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State | IL
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Zip | 60941-5009
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Country | US
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Telephone | 847-363-2368
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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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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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