Provider Demographics
NPI:1063092344
Name:KELLY EBELS COUNSELING PLLC
Entity type:Organization
Organization Name:KELLY EBELS COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:EBELS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:206-489-9810
Mailing Address - Street 1:1623 E 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-4021
Mailing Address - Country:US
Mailing Address - Phone:206-489-9810
Mailing Address - Fax:509-323-1607
Practice Address - Street 1:104 S FREYA ST STE 119
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-4893
Practice Address - Country:US
Practice Address - Phone:206-489-9810
Practice Address - Fax:509-323-1607
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-12
Last Update Date:2021-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty