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NPI Code Detail

MEDICARE: MICHELLE MAY KELLY LMFT

MEDICARE: MICHELLE MAY KELLY LMFT
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
1106H00000XMarriage & Family Therapist119787CA

General Provider Information

NPI Number : 1275309130
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE MAY KELLY LMFT
Provider Business Mailing Address
First Line : 875 S WESTLAKE BLVD STE 211
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91361-2925
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 875 S WESTLAKE BLVD STE 211
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91361-2925
Country : US
Telephone Number : 818-963-0272
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2023
Last Update Date : 11/30/2023

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Directions to “ MICHELLE MAY KELLY LMFT” Practice Location

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