Healthcare Provider Details

I. General information

NPI: 1023036266
Provider Name (Legal Business Name): MICHELLE KELSEY-PLUMMER MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MICHELLE KELSEY PLUMMER MSW, LCSW

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 EAST 7TH STREET
LONG BEACH CA
90822
US

IV. Provider business mailing address

5901 E 7TH ST
LONG BEACH CA
90822-5201
US

V. Phone/Fax

Practice location:
  • Phone: 562-826-5918
  • Fax: 562-826-5244
Mailing address:
  • Phone: 562-826-5918
  • Fax: 562-826-5244

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number072282
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0011972
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: