Healthcare Provider Details

I. General information

NPI: 1023104833
Provider Name (Legal Business Name): EMILY HUFFMAN KELLY BA, MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 11/29/2025
Certification Date: 11/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62 DERBY ST STE 15
HINGHAM MA
02043-3718
US

IV. Provider business mailing address

62 DERBY ST STE 15
HINGHAM MA
02043-3718
US

V. Phone/Fax

Practice location:
  • Phone: 617-827-7395
  • Fax: 781-740-8212
Mailing address:
  • Phone: 617-827-7395
  • Fax: 781-740-8212

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLICSW115388
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: