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NPI Code Detail

MEDICARE: LORRAINE KELLY MS, LPCC-S

MEDICARE: LORRAINE KELLY MS, LPCC-S
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
1101YP2500XProfessional CounselorE.0002249-SUPVOH

General Provider Information

NPI Number : 1336230309
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORRAINE KELLY MS, LPCC-S
Provider Business Mailing Address
First Line : 2980 BELMONT AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44505-1834
Country : US
Telephone Number : 330-759-2310
Fax Number : 330-759-0018
Provider Business Practice Location Address
First Line : 2980 BELMONT AVE
Second Line :
City : YOUNGSTOWN
State : OH
Zip : 44505-1834
Country : US
Telephone Number : 330-759-2310
Fax Number : 330-759-0018
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2006
Last Update Date : 06/23/2020

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Directions to “ LORRAINE KELLY MS, LPCC-S” Practice Location

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