Carrie L Kelly, LPC, SACIT | |
W4051 County Road Nn, Elkhorn, WI 53121-4338 | |
(262) 741-3200 | |
(262) 741-3217 |
Full Name | Carrie L Kelly |
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Gender | Female |
Speciality | Counselor - Professional |
Location | W4051 County Road Nn, Elkhorn, Wisconsin |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1821263724 | NPI | - | NPPES |
1821263724 | Medicaid | WI | |
30604011 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 4558-125 (Wisconsin) | Primary |
Entity Name | Prohealth Medical Group Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356322440 PECOS PAC ID: 3476465188 Enrollment ID: O20031103000066 |
Mailing Address | Practice Location Address |
---|---|
Carrie L Kelly, LPC, SACIT Po Box 1005, Elkhorn, WI 53121-1005 Ph: (262) 741-3200 | Carrie L Kelly, LPC, SACIT W4051 County Road Nn, Elkhorn, WI 53121-4338 Ph: (262) 741-3200 |
Jacquelyn Rupnik, LPC-WI-4813-125 Counselor Medicare: Medicare Enrolled Practice Location: W4051 County Road Nn, Elkhorn, WI 53121 Phone: 262-741-3200 | |
Mrs. Bonnie L Connolly, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 1/2 W Geneva St, Credence Therapy Associates, Elkhorn, WI 53121 Phone: 262-723-3424 Fax: 262-723-8308 | |
Linda Flahive Hornak, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: W4063 Hwy Nn, Elkhorn, WI 53121 Phone: 262-741-1440 Fax: 262-743-2221 | |
Mark Weitkum, SAC-IT Counselor Medicare: Not Enrolled in Medicare Practice Location: 797 E Geneva St, Elkhorn, WI 53121 Phone: 262-723-1455 Fax: 262-723-1556 | |
Catherine L Griffith, SAC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1910 County Road Nn, Elkhorn, WI 53121 Phone: 262-741-3200 Fax: 262-741-3217 | |
Julie Valler, MS, LPC, SACIT Counselor Medicare: Not Enrolled in Medicare Practice Location: W4051 County Road Nn, Elkhorn, WI 53121 Phone: 262-741-3200 Fax: 262-741-3217 | |
Timothy Swanson, MS, LCPC, LPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 1 1/2 W Geneva St, Elkhorn, WI 53121 Phone: 262-723-3424 Fax: 262-723-8308 |