1952455545 NPI number — MRS. KELLY MARIE LAJOIE MBS, LPC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952455545 NPI number — MRS. KELLY MARIE LAJOIE MBS, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAJOIE
Provider First Name:
KELLY
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MBS, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CRAIG
Provider Other First Name:
KELLY
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952455545
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 W 37TH ST FL 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10018-4252
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-317-6081
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3006 EUNICE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRING HILL
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34609-3421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-317-6081
Provider Business Practice Location Address Fax Number:
580-298-6699
Provider Enumeration Date:
01/22/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  3790 , registered in the state of OK ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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