Kavanagh, Kelly A

Kavanagh, Kelly A is an sole proprietor health care provider with primary practice located at 3010 Grand Ave , Waukegan IL 60085-2321. 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. Kavanagh, Kelly A can be contacted via phone (847) 377-8950.

Contact Information

Primary practice address
3010 Grand Ave Waukegan IL 60085-2321
Phone: (847) 377-8950
Fax: (847) 984-5602
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 150.013270 Illinois
Behavioral Health & Social Service Providers / Clinical 1041C0700X 149.022674 Illinois

Profile Details

NPI number 1306111703
LBN Legal business name Kavanagh, Kelly A
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 19th, 2012
Last updated Dec 30th, 2020 - about 6 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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