Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RYAN KELLOG
ActiveMental Health Counselor · EAST PEORIA, IL
Registration Details
- NPI Number
- 1114556719
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 6, 2020 (6.0827108567056 yrs)
- Last Updated
- Apr 6, 2020
Practice Information
- Address
-
111 W WASHINGTON ST STE 203EAST PEORIA, IL, 616112532Browse IL providers · Browse ZIP 61611
- Phone
- 3096718060
- Primary Specialty
-
Mental Health Counselor
101YM0800X
Other Mental Health Counselor Providers in EAST PEORIA, IL
| Name | Credential | NPI |
|---|---|---|
| LILLIAN MERCHANT-SULLIVAN | PHD LCPC | 1629033279 |
| KEVIN J SCHROCK | O. T. | 1255482543 |
| DANIELLE MCCOY | LCPC | 1174141220 |
| ELENA JENKINS | — | 1013620723 |
| KYLE PEARSON | LCPC, NCC, CADC | 1679268916 |
| REKA BROOKS | — | 1093531006 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.