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NPI Code Detail

MEDICARE: KELSEY SYLVESTER

MEDICARE: KELSEY SYLVESTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorA1309118AR

General Provider Information

NPI Number : 1063841518
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY SYLVESTER
Provider Business Mailing Address
First Line : 1000 CHINABERRY DR STE 900
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111-2455
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 4306 S GRAND ST
Second Line :
City : MONROE
State : LA
Zip : 71202-6322
Country : US
Telephone Number : 318-324-5441
Fax Number : 318-324-5442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2013
Last Update Date : 04/11/2025

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Directions to “ KELSEY SYLVESTER ” Practice Location

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