Individual
KEVIN ELSEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
215 HIGHLAND AVE STE C, HADDON TOWNSHIP, NJ 08108-2634
(856) 854-3155
Mailing address
19 TARA DR, MOUNT LAUREL, NJ 08054-9588
(609) 929-5737
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
37AC00344600
NJ
101YP2500X
Professional Counselor
Primary
37PC00745900
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
37PC00745900
DEPARTMENT OF CONSUMER AFFAIRS
NJ
Enumeration date
02/08/2019
Last updated
03/04/2022
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