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Individual
MR. PETER V KELSEY
Active
Individual
MR. PETER V KELSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1019502
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P05617
BCBS PPO
MA
01
—
PP0210
BCBS INDEMNITY
MA
Enumeration date
01/29/2007
Last updated
07/08/2007
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