Individual
MS. DEBORAH ANN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
1205 CENTRAL ST, LEOMINSTER, MA 01453-5903
(978) 537-1835
Mailing address
1205 CENTRAL ST, LEOMINSTER, MA 01453-5903
(978) 537-1835
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1016244
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005527
VALUE OPTIONS
MA
01
—
171035
MAGELLAN
MA
01
—
55449731
UNITED BEHAVIORAL HEALTH
MA
01
—
7104711
BLUE CROSS BLUE SHIELD
MA
01
—
717551
TUFTS HEALTH PLAN ID
MA
01
—
SO28275
CHAMPUS
MA
Enumeration date
11/05/2006
Last updated
07/08/2007
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