MEDICARE: KELSEY MCGILL MA, PCLC, NCC, LSC

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1598451833
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELSEY MCGILL MA, PCLC, NCC, LSC

Provider Business Mailing Address
First Line	:	415 N HIGGINS AVE STE 12
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-4559
Country	:	US
Telephone Number	:	406-686-1007
Fax Number	:

Provider Business Practice Location Address
First Line	:	415 N HIGGINS AVE STE 12
Second Line	:
City	:	MISSOULA
State	:	MT
Zip	:	59802-4559
Country	:	US
Telephone Number	:	406-686-1007
Fax Number	:

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

Provider Enumeration Date	:	04/11/2023
Last Update Date	:	08/24/2023

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