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General NPI Number Information
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NPI Number | 1982586087
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Entity Type | Individual
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Provider Name | KELLY O' LAUGHLIN LMSWCC
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Gender | Female
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Dates
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Enumeration Date | 07/22/2025
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 70 KINGSLAND XING
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City | ELLSWORTH
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State | ME
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Zip | 04605-2570
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Country | US
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Telephone | 800-244-6431
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Fax |
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Provider Business Mailing Address
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Address Line | 180 ACADEMY ST STE 3
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City | PRESQUE ISLE
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State | ME
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Zip | 04769-3183
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Country | US
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Telephone | 207-554-2351
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | MC24741
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License Number State | ME
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