Kelly, Dale

Kelly, Dale is an individual health care provider with primary practice located at 722 Bradley St , Mamaroneck NY 10543-1701. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Kelly, Dale can be contacted via phone (914) 450-7555.

Contact Information

Primary practice address
722 Bradley St Mamaroneck NY 10543-1701
Phone: (914) 450-7555
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 062781-1 New York

Profile Details

NPI number 1033314059
LBN Legal business name Kelly, Dale
Credentials Certified Social Worker (CSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2007
Last updated Jun 13th, 2016 - about 8 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 1033314059 NPPES
New York Other 037355F MAGELLAN EMP BCBS
New York Other 12076 MAGELLAN EMP BCBS
New York MEDICAID 00868635 MAGELLAN EMP BCBS

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