Individual
MR. TIMOTHY JOSEPH KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CASAC-T , B.S, CDC
Contact information
Practice address
41 PAGE PARK DR STE 7, POUGHKEEPSIE, NY 12603-7501
(845) 486-2950
Mailing address
41 PAGE PARK DR STE 7, POUGHKEEPSIE, NY 12603-7501
(845) 486-2950
(845) 486-2999
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
34319
NY
Other
Enumeration date
09/23/2022
Last updated
10/19/2022
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