National Provider Identifier

Kelsey Krueger Cannan, LMHC

Kelsey Krueger Cannan, LMHC is listed in the NPPES registry with a primary specialty of Mental Health Counselor in Fairport, NY and a listed phone number of (585) 690-7501.

NPI 1942794151Fairport, NYMental Health Counselor

Profile Overview

NPI
1942794151
Provider Type
Individual
Primary Specialty
Mental Health Counselor
Enumeration Date
June 20, 2018
Last Updated
June 29, 2023

Practice Location

  • 21 Gentian Way
  • Fairport, NY 14450-9210

Phone: (585) 690-7501

Specialties

  • Mental Health Counselor (101YM0800X)
  • Mental Health Counselor (101YM0800X)
Full Record
NPI
1942794151
Entity Type
Individual
Last Name
Cannan
First Name
Kelsey
Middle Name
Krueger
Credential
LMHC
Provider Other Last Name
Krueger
Provider Other First Name
Kelsey
Provider Other Middle Name
M
Provider Other Credential Text
LMHC
Provider Other Last Name Type Code
2
Mailing Street Address
21 Gentian Way
Mailing City
Fairport
Mailing State
NY
Mailing ZIP Code
14450-9210
Mailing Country
US
Mailing Phone
(585) 690-7501
Practice Street Address
21 Gentian Way
Practice City
Fairport
Practice State
NY
Practice ZIP Code
14450-9210
Practice Country
US
Practice Phone
(585) 690-7501
Enumeration Date
June 20, 2018
Last Updated
June 29, 2023
Sex
Female
Sole Proprietor
Yes
Certification Date
June 29, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Mental Health Counselor (101YM0800X), Mental Health Counselor (101YM0800X)