MEDICARE: KELSEY RAE HARWOOD LMHP, LPC

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
1	101YM0800X	Mental Health Counselor	5184	NE

General Provider Information

NPI Number	:	1255753224
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY RAE HARWOOD LMHP, LPC

Provider Business Mailing Address
First Line	:	8790 F ST STE 127
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68127-1529
Country	:	US
Telephone Number	:	402-525-0801
Fax Number	:

Provider Business Practice Location Address
First Line	:	8790 F ST STE 127
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68127-1529
Country	:	US
Telephone Number	:	402-525-0801
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2014
Last Update Date	:	10/06/2023

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