Provider Demographics
NPI:1548607518
Name:SAJDAK, KELLE (LPC, MA)
Entity type:Individual
Prefix:MS
First Name:KELLE
Middle Name:
Last Name:SAJDAK
Suffix:
Gender:F
Credentials:LPC, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4122 ALPHA ST
Mailing Address - Street 2:APT 16
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-4750
Mailing Address - Country:US
Mailing Address - Phone:734-626-6113
Mailing Address - Fax:
Practice Address - Street 1:4572 S HAGADORN RD
Practice Address - Street 2:#1C
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5385
Practice Address - Country:US
Practice Address - Phone:517-481-2133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-30
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401012822101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor