Kelly, Stephanie

Kelly, Stephanie is an individual health care provider with primary practice located at 1300 Camino Sierra Vis 129, Santa Fe NM 87505-1007. She recently has only one registered license in Behavioral Health & Social Service Providers / School, which is considered as her primary health care specialty. Kelly, Stephanie can be contacted via phone (505) 310-2571.

Contact Information

Primary practice address
1300 Camino Sierra Vis 129 Santa Fe NM 87505-1007
Phone: (505) 310-2571
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / School 1041S0200X M-0123 New Mexico

Profile Details

NPI number 1215150107
LBN Legal business name Kelly, Stephanie
Credentials LMSW
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2007
Last updated Jul 8th, 2007 - about 17 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 1215150107 NPPES
New Mexico MEDICAID M-05273

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