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Individual

MRS. HEATHER LYNNE KELLAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSWC

Contact information

Practice address
2336 GODDARD PARKWAY, SALISBURY, MD 21801
(410) 334-6961
(410) 334-6362
Mailing address
2336 GODDARD PKWY, SALISBURY, MD 21801-1126
(410) 334-6961
(410) 334-6960

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13217
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0035
CAREFIRST BCBS-FED-PIN
MD
01
259147000
MAGELLAN GROUP
MD
01
517251
UHC MAMSI GROUP
01
522156095
AMERICAN PSYCH SYSTEM
MD
05
609550001
MD
01
893100-01
CAREFIRST BCBS PIN
MD
01
LM49EA
CAREFIRST BCBS GROUP
MD
01
R968
CAREFIRST FEDERAL GROUP
Enumeration date
11/08/2006
Last updated
12/14/2011
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