Provider Demographics
NPI:1588340145
Name:UMSCHEID, KELLI JEAN
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:JEAN
Last Name:UMSCHEID
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:JEAN
Other - Last Name:SHATTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:154 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-2806
Mailing Address - Country:US
Mailing Address - Phone:785-577-3388
Mailing Address - Fax:
Practice Address - Street 1:154 S 7TH ST
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-2806
Practice Address - Country:US
Practice Address - Phone:785-577-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4186101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional