Individual
KELSIE JANE LINDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
136 SHERMAN AVE, NEW HAVEN, CT 06511-5238
(203) 586-4264
Mailing address
180 FAIRFIELD AVE, BRIDGEPORT, CT 06604-4252
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
1041C0700X
Clinical Social Worker
Primary
11170
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06-0669106
—
CT
Enumeration date
07/13/2017
Last updated
09/21/2023
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