Kelly, Alexis Catherine

Kelly, Alexis Catherine is an sole proprietor health care provider with primary practice located at 1509 N Main Ave , Scranton PA 18508-1866. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Student, Health Care / Student in an Organized Health Care Education/Training Program. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Kelly, Alexis Catherine can be contacted via phone (570) 407-3869.

Contact Information

Primary practice address
1509 N Main Ave Scranton PA 18508-1866
Phone: (570) 407-3869
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X CW018969 Pennsylvania
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1306129960
LBN Legal business name Kelly, Alexis Catherine
Credentials MSW, LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 21st, 2011
Last updated Jan 4th, 2017 - about 9 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1306129960 NPPES
Connecticut MEDICAID 008003511

Popular Providers