| Alisha Kelley Lcsw,llc | |
|
401 Ne 19th Ave Ste 200 Portland OR 97232-4800 | |
| (971) 377-9506 | |
| Not Available |
| Full Name | Alisha Kelley Lcsw,llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 401 Ne 19th Ave Ste 200, Portland, Oregon |
| Authorized Official Name and Position | Alisha Inez Kelley (SOCIAL WORKER) |
| Authorized Official Contact | 5033582146 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alisha Kelley Lcsw,llc 401 Ne 19th Ave Ste 200 Portland OR 97232-4800 Ph: (503) 358-2146 | Alisha Kelley Lcsw,llc 401 Ne 19th Ave Ste 200 Portland OR 97232-4800 Ph: (971) 377-9506 |
| NPI Number | 1972279370 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 10/20/2023 |
| Certification Date | 10/20/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972279370 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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