MEDICARE: MRS. KELLY KATHLEEN KAZSIMER MSCP, 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	101YP2500X	Professional Counselor	PC007214	PA

General Provider Information

NPI Number	:	1952731127
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KELLY KATHLEEN KAZSIMER MSCP, LPC

Provider Business Mailing Address
First Line	:	100 NORTH POINTE CIRCLE
Second Line	:	SUITE 306
City	:	SEVEN FIELDS
State	:	PA
Zip	:	16046
Country	:	US
Telephone Number	:	724-772-4848
Fax Number	:

Provider Business Practice Location Address
First Line	:	3402 WASHINGTON RD
Second Line	:	SUITE 304
City	:	MC MURRAY
State	:	PA
Zip	:	15317-2964
Country	:	US
Telephone Number	:	724-941-5363
Fax Number	:

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

Provider Enumeration Date	:	11/25/2013
Last Update Date	:	11/25/2013

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