Kelly, Kevin William

Kelly, Kevin William is an sole proprietor health care provider with primary practice located at 2013 State Street , East Petersburg PA 17520-1216. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Kelly, Kevin William can be contacted via phone (717) 291-8283.

Contact Information

Primary practice address
2013 State Street East Petersburg PA 17520-1216
Phone: (717) 291-8283
Fax: (717) 581-6528
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PS-008835-L Pennsylvania

Profile Details

NPI number 1619984309
LBN Legal business name Kelly, Kevin William
Credentials PSY.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 2nd, 2006
Last updated Feb 10th, 2010 - about 16 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 1619984309 NPPES
Pennsylvania Other 000411068 HIGHMARK BLUE SHIELD #
Pennsylvania Other 01786901 HIGHMARK BLUE SHIELD #
Pennsylvania Other 458436 HIGHMARK BLUE SHIELD #
Pennsylvania Other P00180931 HIGHMARK BLUE SHIELD #
Pennsylvania Other 02695800 HIGHMARK BLUE SHIELD #

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