Provider Demographics
NPI:1376427468
Name:KERRIGAN, KELSY J
Entity type:Individual
Prefix:
First Name:KELSY
Middle Name:J
Last Name:KERRIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 E JEANETTE ST
Mailing Address - Street 2:
Mailing Address - City:HERSCHER
Mailing Address - State:IL
Mailing Address - Zip Code:60941-5009
Mailing Address - Country:US
Mailing Address - Phone:847-363-2368
Mailing Address - Fax:
Practice Address - Street 1:807 LIBERTY DR STE 106
Practice Address - Street 2:
Practice Address - City:VERONA
Practice Address - State:WI
Practice Address - Zip Code:53593-9160
Practice Address - Country:US
Practice Address - Phone:608-819-6394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-02
Last Update Date:2025-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health