NPI 1245824804

Patrick K Kelley, CSACICS

Practitioner Addiction (Substance Use Disorder) Counselor Viroqua, WI

Practice location

Address: 1321 N Main St, Viroqua, WI 54665-1156
Phone: (608) 637-7052
Fax: (608) 785-0002
Mailing address: 1707 Main St, La Crosse, WI 54601-4200

Registered specialties

Addiction (Substance Use Disorder) Counselor Primary

Behavioral Health & Social Service Providers Taxonomy 101YA0400X Licence 16004 (WI)

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Registry record

NPI: 1245824804
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Feb 2021
Record last updated: 24 Feb 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.