Koebel, Kelly Luther

Koebel, Kelly Luther is an individual health care provider with primary practice located at 24 Clay St , Martinsville VA 24112-2810. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Koebel, Kelly Luther can be contacted via phone (276) 632-7128.

Contact Information

Primary practice address
24 Clay St Martinsville VA 24112-2810
Fax: (276) 632-0127
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701004759 Virginia

Profile Details

NPI number 1164753935
LBN Legal business name Koebel, Kelly Luther
Credentials Licensed Professional Counselor (LPC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 19th, 2010
Last updated Feb 20th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164753935 NPPES
Virginia MEDICAID 004945221

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