Kelly, Barbara
Kelly, Barbara is an individual health care provider with primary practice located at 475 Clinton Ave , Bridgeport CT 06605-1700. She recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as her primary health care specialty. Kelly, Barbara can be contacted via phone (203) 368-5515.Contact Information
Primary practice address
475 Clinton Ave
Bridgeport CT 06605-1700
Phone: (203) 368-5515
Fax: (203) 368-9167
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Professional | 101YP2500X | 002178 | Connecticut |
Profile Details
| NPI number | 1114284601 |
|---|---|
| LBN Legal business name | Kelly, Barbara |
| Credentials | Licensed Professional Counselor (LPC) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 20th, 2012 |
| Last updated | Apr 20th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114284601 | NPPES |
| Connecticut | MEDICAID | 004069985 |
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