Healthcare Provider Details

I. General information

NPI: 1306782115
Provider Name (Legal Business Name): KELLY ARNOLD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 WHITING STREET SUITE 3
HINGHAM MA
02043
US

IV. Provider business mailing address

64 CHARLEMONT ST
DORCHESTER MA
02122-2118
US

V. Phone/Fax

Practice location:
  • Phone: 781-226-1652
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCSW2142053
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: