| Jennifer Kelsch Licensed Clinical Social Worker Pc | |
|
991 Main St Suite 201 Holbrook NY 11741-1608 | |
| (631) 875-3549 | |
| (631) 588-8900 |
| Full Name | Jennifer Kelsch Licensed Clinical Social Worker Pc |
|---|---|
| Speciality | Social Worker |
| Location | 991 Main St, Holbrook, New York |
| Authorized Official Name and Position | Jennifer Lynn Kelsch (CLINICAL SOCIAL WORKER) |
| Authorized Official Contact | 6318753549 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jennifer Kelsch Licensed Clinical Social Worker Pc 991 Main St Holbrook NY 11741-1608 Ph: (631) 875-3549 | Jennifer Kelsch Licensed Clinical Social Worker Pc 991 Main St Suite 201 Holbrook NY 11741-1608 Ph: (631) 875-3549 |
| NPI Number | 1609326206 |
|---|---|
| Provider Enumeration Date | 10/06/2016 |
| Last Update Date | 10/06/2016 |
| Medicare PECOS PAC ID | 3678859287 |
|---|---|
| Medicare Enrollment ID | O20170414000361 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609326206 | NPI | - | NPPES |
| A400063881 | Other | MEDICARE NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 077692 (New York) | Primary |
| Provider Name | Jennifer L Kelsch |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1346530680 PECOS PAC ID: 6608035027 Enrollment ID: I20120305000336 |
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