Healthcare Provider Details

I. General information

NPI: 1811787161
Provider Name (Legal Business Name): KELSEY ANN CASPER LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/09/2025
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

375 N MAIN ST STE B3
WILLIAMSTOWN NJ
08094-1475
US

IV. Provider business mailing address

191 POLK LN
BRIDGETON NJ
08302-5905
US

V. Phone/Fax

Practice location:
  • Phone: 856-472-0102
  • Fax:
Mailing address:
  • Phone: 856-305-2451
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL06851800
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: