Healthcare Provider Details

I. General information

NPI: 1215841275
Provider Name (Legal Business Name): KELSEY KUHN LAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 N SUSSEX ST STE 315
DOVER NJ
07801-3911
US

IV. Provider business mailing address

4 ORCHARD ST
WHARTON NJ
07885-2222
US

V. Phone/Fax

Practice location:
  • Phone: 973-314-2929
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37AC00822300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: