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53 High St # A26 Westerly RI 02891-6027 | |
| (860) 294-9777 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Social Worker |
| Location | 53 High St # A26, Westerly, Rhode Island |
| Authorized Official Name and Position | Michele Kelly (OWNER THERAPIST) |
| Authorized Official Contact | 8602949777 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
27 Bitgood Rd Griswold CT 06351-1503 Ph: (860) 576-7834 | 53 High St # A26 Westerly RI 02891-6027 Ph: (860) 294-9777 |
| NPI Number | 1760227334 |
|---|---|
| Provider Enumeration Date | 06/26/2024 |
| Last Update Date | 12/04/2024 |
| Certification Date | 12/04/2024 |
| Medicare PECOS PAC ID | 7810434040 |
|---|---|
| Medicare Enrollment ID | O20240805003786 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760227334 | NPI | - | NPPES |
| 1326573312 | Other | CT | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| Provider Name | Michele Kelly |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1326573312 PECOS PAC ID: 0345527768 Enrollment ID: I20221031000521 |
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