| Kelley Fulkerson Counseling, Llc | |
|
2817 Veach Rd Owensboro KY 42303-6252 | |
| (270) 240-5312 | |
| (270) 495-4305 |
| Full Name | Kelley Fulkerson Counseling, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2817 Veach Rd, Owensboro, Kentucky |
| Authorized Official Name and Position | Kelley Fulkerson (LCSW) |
| Authorized Official Contact | 2702405312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelley Fulkerson Counseling, Llc 2817 Veach Rd Owensboro KY 42303-6252 Ph: (270) 240-5312 | Kelley Fulkerson Counseling, Llc 2817 Veach Rd Owensboro KY 42303-6252 Ph: (270) 240-5312 |
| NPI Number | 1487427894 |
|---|---|
| Provider Enumeration Date | 11/07/2023 |
| Last Update Date | 04/17/2024 |
| Certification Date | 04/17/2024 |
| Medicare PECOS PAC ID | 0345690871 |
|---|---|
| Medicare Enrollment ID | O20231227000258 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1487427894 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Kelley Fulkerson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578942140 PECOS PAC ID: 4385070036 Enrollment ID: I20200129000447 |
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