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Organization
JENNIFER KELSCH LICENSED CLINICAL SOCIAL WORKER PC
Active
Organization
JENNIFER KELSCH LICENSED CLINICAL SOCIAL WORKER PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JENNIFER LYNN KELSCH LCSW-R (CLINICAL SOCIAL WORKER)
(631) 875-3549
Entity
Organization
Contact information
Practice address
991 MAIN ST, SUITE 201, HOLBROOK, NY 11741-1608
(631) 875-3549
(631) 588-8900
Mailing address
991 MAIN ST, HOLBROOK, NY 11741-1608
(631) 875-3549
(631) 588-8900
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
077692
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A400063881
MEDICARE NUMBER
—
Enumeration date
10/06/2016
Last updated
10/06/2016
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