Individual
CARYN KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
607 7TH ST, WILMETTE, IL 60091-1919
(847) 251-0332
(847) 251-0332
Mailing address
607 7TH ST, WILMETTE, IL 60091-1919
(847) 251-0332
(847) 251-0332
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.003207
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
149.003207
LICENSED CLINICAL SOCIAL WORKER
IL
Enumeration date
07/26/2013
Last updated
07/26/2013
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