Provider Demographics
NPI:1336691286
Name:SEMENTELLI, KELLY LYNN (LMHC)
Entity type:Individual
Prefix:MISS
First Name:KELLY
Middle Name:LYNN
Last Name:SEMENTELLI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5842 MAIN ST STE 2B
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-5710
Mailing Address - Country:US
Mailing Address - Phone:716-912-6656
Mailing Address - Fax:716-529-0031
Practice Address - Street 1:5842 MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-5710
Practice Address - Country:US
Practice Address - Phone:716-912-6656
Practice Address - Fax:716-529-0031
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-26
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X
NY009947101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)