| Doctor Name: | JANICE KELLY |
| NPI Number: | 1013181452 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CSW |
| License Number: | 067965 |
| Business Practice Address: | 1000 N. Village Avenue Rockville Centre, NY - 11571 |
| Business Phone Number: | 5167051353 |
| Business Fax Number: | 5167052878 |
| Mailing Address: | P.o. Box 798, ROCKVILLE CENTRE |
| State: | NY |
| Postal Code: | 11571 |
| Phone Number: | 5167051353 |
| Fax Number: | 5167052878 |
| NPI Enumeration Date: | 04/16/2008 |
| NPI Last Update Date: | 04/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 067965 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |