Provider Demographics
NPI:1336625466
Name:BUSBEE, KELLI (LPC)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:BUSBEE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 GUM BAYOU LN
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-1671
Mailing Address - Country:US
Mailing Address - Phone:985-640-0773
Mailing Address - Fax:985-273-5088
Practice Address - Street 1:59015 AMBER ST STE A3
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70461-5398
Practice Address - Country:US
Practice Address - Phone:985-640-0773
Practice Address - Fax:985-273-5088
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6533101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional