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NPI Code Detail

MEDICARE: LEAH MICHELLE KELLEY LMSW

MEDICARE: LEAH MICHELLE KELLEY LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerMSW009959GA

General Provider Information

NPI Number : 1750096046
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEAH MICHELLE KELLEY LMSW
Provider Business Mailing Address
First Line : 1381 LA FRANCE ST NE
Second Line :
City : ATLANTA
State : GA
Zip : 30307-2764
Country : US
Telephone Number : 734-417-8039
Fax Number :
Provider Business Practice Location Address
First Line : 3232 MEMORIAL DR
Second Line :
City : DECATUR
State : GA
Zip : 30032-3419
Country : US
Telephone Number : 404-783-2079
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2023
Last Update Date : 03/28/2023

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Directions to “ LEAH MICHELLE KELLEY LMSW” Practice Location

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