| Kelly Winslow Lcsw, Llc | |
|
4055 S 700 E Ste 103 Millcreek UT 84107-2508 | |
| (801) 879-8933 | |
| Not Available |
| Full Name | Kelly Winslow Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 4055 S 700 E Ste 103, Millcreek, Utah |
| Authorized Official Name and Position | Kelly Winslow (OWNER) |
| Authorized Official Contact | 8018798933 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Winslow Lcsw, Llc 4055 S 700 E Ste 103 Millcreek UT 84107-2508 Ph: () - | Kelly Winslow Lcsw, Llc 4055 S 700 E Ste 103 Millcreek UT 84107-2508 Ph: (801) 879-8933 |
| NPI Number | 1265127716 |
|---|---|
| Provider Enumeration Date | 04/10/2023 |
| Last Update Date | 08/31/2023 |
| Certification Date | 08/31/2023 |
| Medicare PECOS PAC ID | 5991167041 |
|---|---|
| Medicare Enrollment ID | O20230822000719 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265127716 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Kelly Winslow |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871258707 PECOS PAC ID: 7315314903 Enrollment ID: I20221111000209 |
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