Provider Demographics
NPI:1922549955
Name:SMITH, KELLI H (MED, LPC-S)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:H
Last Name:SMITH
Suffix:
Gender:F
Credentials:MED, LPC-S
Other - Prefix:
Other - First Name:KELLI
Other - Middle Name:R
Other - Last Name:HOLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4315 BLUEBONNET BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70809-9661
Mailing Address - Country:US
Mailing Address - Phone:225-978-3745
Mailing Address - Fax:225-351-9067
Practice Address - Street 1:4315 BLUEBONNET BLVD STE B
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-9661
Practice Address - Country:US
Practice Address - Phone:225-978-3745
Practice Address - Fax:225-351-9067
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-09
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6266101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health