Individual
KELLY MEANY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW, LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1330
CT
1041C0700X
Clinical Social Worker
Primary
11495
CT
171M00000X
Case Manager/Care Coordinator
098303
NY
Other
Enumeration date
08/10/2016
Last updated
09/02/2021
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