Kelley Mires

Individual provider Active NPI Mental Health Counselor · New Palestine, IN

NPI 1700285202 · NPPES record last updated Aug 20, 2014

Key facts

NPI
1700285202
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
Practice address
6392 W 300 S
New Palestine, IN 46163-9748
Phone
(317) 340-9875
NPI assigned
Aug 20, 2014
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X IN Yes

Addresses

Primary practice location

6392 W 300 S
New Palestine, IN 46163-9748

Mailing address

6392 W 300 S
New Palestine, IN 46163-9748
Phone (317) 340-9875

Other identifiers

IdentifierTypeStateIssuer
201033170 AMedicaidIN

Other providers in New Palestine, IN

All providers in New Palestine, IN · Mental Health Counselor in Indiana

Sources for this page

Verify at the official NPI Registry.