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General NPI Number Information
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NPI Number | 1912676545
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Entity Type | Organization
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Legal Business Name | KELLY AKEHURST LPC LLC
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Dates
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Enumeration Date | 09/08/2021
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Last Update Date | 09/08/2021
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Provider Practice Location Address
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Address Line | 270 GREENWICH AVE STE 19
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City | GREENWICH
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State | CT
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Zip | 06830-6530
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Country | US
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Telephone | 475-477-0278
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Fax |
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Provider Business Mailing Address
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Address Line | 46 PEQUOT LN
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City | NEW CANAAN
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State | CT
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Zip | 06840-2020
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Country | US
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Telephone | 475-477-0248
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Fax |
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Authorized Official
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Title or Position | LICENSED PROFESSIONAL COUNSELOR
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Name | KELLY AKEHURST
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Credential | MA
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Telephone | 475-477-0278
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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