Individual
MS. CAITLIN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
484 W 43RD ST APT 23H, NEW YORK, NY 10036-6341
(212) 564-5228
Mailing address
484 W 43RD ST APT 23H, NEW YORK, NY 10036-6341
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
005743-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005743-1
MENTAL HEALTH COUNSELOR
NY
Enumeration date
08/22/2019
Last updated
08/22/2019
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