Provider Demographics
NPI:1306539481
Name:KELM, ERICA S (LPC-INTERN)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:S
Last Name:KELM
Suffix:
Gender:F
Credentials:LPC-INTERN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 AMBERGATE DR
Mailing Address - Street 2:
Mailing Address - City:SHADY SHORES
Mailing Address - State:TX
Mailing Address - Zip Code:76208-5551
Mailing Address - Country:US
Mailing Address - Phone:214-542-3161
Mailing Address - Fax:
Practice Address - Street 1:2214 EMERY ST STE 510
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2476
Practice Address - Country:US
Practice Address - Phone:940-239-3575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health