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NPI Code Detail

MEDICARE: LAUREN ELIZABETH KELLY

MEDICARE:   LAUREN ELIZABETH KELLY
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 Counselor3699TN

General Provider Information

NPI Number : 1588944581
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ELIZABETH KELLY
Provider Business Mailing Address
First Line : 440 PARK AVE
Second Line :
City : LEBANON
State : TN
Zip : 37087-3664
Country : US
Telephone Number : 615-419-3224
Fax Number :
Provider Business Practice Location Address
First Line : 440 PARK AVE
Second Line :
City : LEBANON
State : TN
Zip : 37087-3664
Country : US
Telephone Number : 615-419-3224
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2011
Last Update Date : 07/13/2020

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Directions to “ LAUREN ELIZABETH KELLY ” Practice Location

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