Doctor Name: | MS. JENNIFER LYNN KELSCH |
NPI Number: | 1346530680 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 077692 |
Business Practice Address: | 2233 Nesconset Hwy Suite 104 Lake Grove, NY - 117551000 |
Business Phone Number: | 6317375559 |
Business Fax Number: | |
Mailing Address: | 2323 Nesconset Highway, Suite 104 LAKE GROVE |
State: | NY |
Postal Code: | 11755 |
Phone Number: | 6317375559 |
Fax Number: | |
NPI Enumeration Date: | 04/07/2011 |
NPI Last Update Date: | 04/07/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 077692 |
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 |