Basic Information
| Provider Information | |||||||||
| NPI: | 1245749845 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FINN | ||||||||
| FirstName: | KELLIE | ||||||||
| MiddleName: | ANN | ||||||||
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| Credential: | LMHC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 46 DODSON WAY | ||||||||
| Address2: | |||||||||
| City: | EAST FALMOUTH | ||||||||
| State: | MA | ||||||||
| PostalCode: | 025367705 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5089892920 | ||||||||
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| Practice Location | |||||||||
| Address1: | 235 N PEARL ST | ||||||||
| Address2: | |||||||||
| City: | BROCKTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 023011794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5084273000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/26/2017 | ||||||||
| LastUpdateDate: | 09/26/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | 10173 | MA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.