Provider Demographics
NPI:1154164168
Name:LITTERER, KELSEY MARIE (T-LMHC)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:MARIE
Last Name:LITTERER
Suffix:
Gender:F
Credentials:T-LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18902 200TH ST
Mailing Address - Street 2:
Mailing Address - City:HAWKEYE
Mailing Address - State:IA
Mailing Address - Zip Code:52147-8223
Mailing Address - Country:US
Mailing Address - Phone:641-923-1745
Mailing Address - Fax:
Practice Address - Street 1:1420 W DONALD ST
Practice Address - Street 2:
Practice Address - City:WATERLOO
Practice Address - State:IA
Practice Address - Zip Code:50703-1624
Practice Address - Country:US
Practice Address - Phone:563-412-9179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA126142101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health