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Mrs. Kelly Deaton Tolliver, MED,LPCC
Mental Health Counselor in Berea, Kentucky
NPI 1417295312

Kelly Deaton Tolliver is a Mental Health Counselor based in Berea, KY and is specialized in Mental Health. Kelly Deaton Tolliver practices in Berea, KY and has the professional credentials of MED,LPCC. The NPI Number for Kelly Deaton Tolliver is 1417295312 and holds a License No. LPCA KY-1506 (Kentucky).

The current practice location address for Kelly Deaton Tolliver is 208 Kidd Dr, Berea, KY and can be reached out via phone at 859-428-7862 and via fax at 859-999-7869.

Location: 208 Kidd Dr, Berea, KY, 40403-0802
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417295312
Provider Name
Kelly Deaton Tolliver
Credential
MED,LPCC
Provider Entity Type
Individual
Gender
Female
Address
208 Kidd Dr, Berea, KY, 40403-0802
Phone Number
859-428-7862
Fax Number
859-999-7869
Provider Enumeration Date
01/28/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
7100573130 05 KY
institution
Provider Business Practice Location Address Details
Address
208 Kidd Dr
City
Berea
State
Kentucky
Zip
40403-9593
Phone Number
859-428-7862
Fax Number
859-999-7869
person
Provider Business Mailing Address Details
Address
208 Kidd Dr
City
Berea
State
Kentucky
Zip
40403-9593
Phone Number
859-428-7862
Fax Number
859-999-7869
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
101YA0400X
License No.
LPCC-KY-245479 (Kentucky)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
245479 (Kentucky)
Definition
Definition to come...
person
Provider's Taxonomy Details 3
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Professional
Taxonomy
101YP2500X
License No.
LPCA KY-1506 (Kentucky)
Definition
Definition to come...
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