Doctor Name: | MRS. WENDY NICOLE KELLY |
NPI Number: | 1205088416 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 44SC04934500 |
Business Practice Address: | 47 Water St Barnegat, NJ - 080052454 |
Business Phone Number: | 6099472224 |
Business Fax Number: | |
Mailing Address: | 31 Main St, TOMS RIVER |
State: | NJ |
Postal Code: | 087537463 |
Phone Number: | 6099472224 |
Fax Number: | |
NPI Enumeration Date: | 10/21/2008 |
NPI Last Update Date: | 07/18/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 44SC04934500 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |