Individual
KELLY E FENWICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
601 LINCOLN PARK RD, SPRINGFIELD, KY 40069-1501
(844) 435-0900
(270) 858-4029
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 858-6655
(270) 858-4027
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
256116
KY
Other
Enumeration date
10/28/2021
Last updated
10/11/2024
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