Clark, Kelsey
Clark, Kelsey is an individual health care provider with primary practice located at 130 Shady Lane Dr , Norwalk OH 44857-2710. She recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as her primary health care specialty. Clark, Kelsey can be contacted via phone (567) 743-7199.Contact Information
Primary practice address
130 Shady Lane Dr
Norwalk OH 44857-2710
Phone: (567) 743-7199
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | S.2005584 | Ohio |
Profile Details
| NPI number | 1174124374 |
|---|---|
| LBN Legal business name | Clark, Kelsey |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 4th, 2020 |
| Last updated | May 3rd, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174124374 | NPPES |
| Ohio | MEDICAID | 0424118 |
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