Kellie Hollingsworth, M.A,, LMFT

Individual provider Active NPI Marriage & Family Therapist · Cody, WY

NPI 1306261102 · NPPES record last updated Apr 26, 2023

Key facts

NPI
1306261102
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
LMFT-202 (WY)
Practice address
1701 Stampede Ave Ste 201
Cody, WY 82414-4818
Phone
(307) 250-8761
NPI assigned
Mar 3, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
LMFT-202WYMDMarriage & Family Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X LMFT-202 WY Yes

Addresses

Primary practice location

1701 Stampede Ave Ste 201
Cody, WY 82414-4818

Mailing address

2419 Ina Ave
Cody, WY 82414-9756
Phone (307) 250-8761

Other providers in Cody, WY

All providers in Cody, WY · Marriage & Family Therapist in Wyoming

Sources for this page

Verify at the official NPI Registry.