Individual
KELLY HA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
282 WASHINGTON ST, HARTFORD, CT 06106-3322
(860) 545-9000
(860) 545-9622
Mailing address
1 GOLD ST APT 3G, HARTFORD, CT 06103-2906
(860) 965-9558
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
13180
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069300390
STATE ID
CT
Enumeration date
08/02/2023
Last updated
11/29/2023
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