Healthcare Provider Details

I. General information

NPI: 1144146523
Provider Name (Legal Business Name): KELSEY LEONE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 S CHAPEL GATE LN
BALTIMORE MD
21229-3906
US

IV. Provider business mailing address

1516 S CHARLES ST
BALTIMORE MD
21230-4415
US

V. Phone/Fax

Practice location:
  • Phone: 419-368-7800
  • Fax:
Mailing address:
  • Phone: 732-284-8531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number32939
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: