Individual
BRIAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
7 PENNSYLVANIA AVE, NEWTON, MA 02464-1357
(774) 306-6540
Mailing address
7 PENNSYLVANIA AVE, NEWTON, MA 02464-1357
(774) 306-6540
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1029609
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
699909
TUFTS
MA
01
—
P07461
BCBS
MA
Enumeration date
11/29/2006
Last updated
04/08/2025
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