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Individual
MR. STEVEN KELLY
Active
Individual
MR. STEVEN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
7364059-3502
UT
1041C0700X
Clinical Social Worker
Primary
7364059-3501
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7364059-3502
CERTIFIED SOCIAL WORKER LICENSE
UT
Enumeration date
07/29/2009
Last updated
06/08/2022
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