Smith, Kellen M

Smith, Kellen M is an individual health care provider with primary practice located at 94 Eagle Point Rd , Fox Lake IL 60020-1764. She recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Smith, Kellen M can be contacted via phone (815) 528-8965.

Contact Information

Primary practice address
94 Eagle Point Rd Fox Lake IL 60020-1764
Phone: (815) 528-8965
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 35098 Illinois
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 30074 Illinois

Profile Details

NPI number 1306281324
LBN Legal business name Smith, Kellen M
Credentials CADC, CODP I
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2013
Last updated Nov 22nd, 2023 - 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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