Individual
KELLI JO CLANCY I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2595
(651) 254-1000
Mailing address
640 JACKSON ST, SAINT PAUL, MN 55101-2595
(651) 254-1000
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
16365
MN
1041S0200X
School Social Worker
16365
MN
Other
Enumeration date
12/25/2025
Last updated
12/25/2025
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