| Loretta Kelly Lcsw Pc | |
|
250 Beachview St Copiague NY 11726-3604 | |
| (631) 805-5668 | |
| Not Available |
| Full Name | Loretta Kelly Lcsw Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 250 Beachview St, Copiague, New York |
| Authorized Official Name and Position | Loretta Kelly (OWNER) |
| Authorized Official Contact | 6318055668 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Loretta Kelly Lcsw Pc 250 Beachview St Copiague NY 11726-3604 Ph: (631) 805-5668 | Loretta Kelly Lcsw Pc 250 Beachview St Copiague NY 11726-3604 Ph: (631) 805-5668 |
| NPI Number | 1376201285 |
|---|---|
| Provider Enumeration Date | 12/08/2021 |
| Last Update Date | 12/08/2021 |
| Certification Date | 12/08/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376201285 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Federation Of Organizations For The New York State For The Mentally Di Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 1375 Akron St, Copiague, NY 11726 Phone: 631-669-5355 Fax: 631-669-1114 |