Doctor Name: | MISS CARLA LOMBARD KELLY |
NPI Number: | 1124213368 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LICSW |
License Number: | 1027792 |
Business Practice Address: | 55 Fogg Rd South Weymouth, MA - 021902432 |
Business Phone Number: | 7813408799 |
Business Fax Number: | 7813408137 |
Mailing Address: | 55 Fogg Rd, S WEYMOUTH |
State: | MA |
Postal Code: | 021902432 |
Phone Number: | 7813408799 |
Fax Number: | 7813408137 |
NPI Enumeration Date: | 09/11/2007 |
NPI Last Update Date: | 09/11/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 1027792 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |