Clark, Kelly

Clark, Kelly is an individual health care provider with primary practice located at 425 Prospect St , Northampton MA 01060-2046. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Clark, Kelly can be contacted via phone (413) 727-2640.

Contact Information

Primary practice address
425 Prospect St Northampton MA 01060-2046
Phone: (413) 727-2640
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X
Behavioral Health & Social Service Providers / Clinical 1041C0700X

Profile Details

NPI number 1881715068
LBN Legal business name Clark, Kelly
Credentials LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2007
Last updated Jan 23rd, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881715068 NPPES
Massachusetts Other 0300010 MBHP
Massachusetts MEDICAID 1300881 MBHP

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