Individual
DR. SEAN F. KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
20 PARK PLZ, SUITE 452, BOSTON, MA 02116-4303
(617) 792-7479
Mailing address
10 WOODLAND RD, BEVERLY, MA 01915-2747
(617) 792-7479
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1698
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0504513
—
MA
01
—
W01759
BLUE SHIELD PROVIDER ID
MA
01
—
W0175925793
TRICARE
MA
Enumeration date
01/23/2007
Last updated
05/27/2016
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