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General NPI Number Information
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NPI Number | 1972938611
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Entity Type | Individual
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Provider Name | KELLI ELIZABETH MCCORMICK LPCC
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Gender | Female
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 05/16/2023
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Provider Practice Location Address
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Address Line | 2901 PIGEON ROOST RD
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City | RUSH
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State | KY
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Zip | 41168-8132
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Country | US
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Telephone | 606-928-6648
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Fax | 69-281-0566
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Provider Business Mailing Address
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Address Line | 2901 PIGEON ROOST RD
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City | RUSH
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State | KY
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Zip | 41168-8132
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Country | US
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Telephone | 606-928-6648
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Fax | 606-928-1056
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 104477
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License Number State | KY
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