Provider Demographics
NPI:1750174181
Name:KELLIE HOPKINS, LICDC, LLC
Entity type:Organization
Organization Name:KELLIE HOPKINS, LICDC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KELLIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:HOPKINS
Authorized Official - Suffix:
Authorized Official - Credentials:LISW, LICDC
Authorized Official - Phone:419-405-3899
Mailing Address - Street 1:3144 WHITE ST
Mailing Address - Street 2:
Mailing Address - City:LAMBERTVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48144-9417
Mailing Address - Country:US
Mailing Address - Phone:419-405-3899
Mailing Address - Fax:419-405-3899
Practice Address - Street 1:5151 MONROE ST STE 200
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3466
Practice Address - Country:US
Practice Address - Phone:419-405-3899
Practice Address - Fax:419-405-3899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty