Individual provider · Type 1 NPI

Jack Kelley

Mental Health Counselor · Hopkinsville, KY

NPI number 1417030461 Active

Practice location

607 Hammond Plz
Hopkinsville, KY 42240-4971

Mailing address

PO Box 614
Hopkinsville, KY 42241-0614

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1417030461

Jack Kelley's National Provider Identifier is 1417030461, issued on Oct 23, 2006. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Hopkinsville, KY. The record was last updated on Jul 8, 2007.