Healthcare Provider Details

I. General information

NPI: 1760117857
Provider Name (Legal Business Name): KATHRYN ELIZABETH KEULMANN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 LIBRARY AVE STE 104
NEWARK DE
19711-7170
US

IV. Provider business mailing address

2601 CLEVELAND AVE
CLAYMONT DE
19703-2447
US

V. Phone/Fax

Practice location:
  • Phone: 302-319-5161
  • Fax:
Mailing address:
  • Phone: 302-743-3240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW025618
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberQ1-0012685
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: