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Individual
SUSAN KELLY
Active
Individual
SUSAN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
128353
MA
1041C0700X
Clinical Social Worker
226340
MA
1041C0700X
Clinical Social Worker
Primary
34661
MD
1041C0700X
Clinical Social Worker
Primary
CSW02593
RI
1041C0700X
Clinical Social Worker
CW025422
PA
Other
Enumeration date
12/21/2021
Last updated
06/15/2026
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