Healthcare Provider Details

I. General information

NPI: 1427967306
Provider Name (Legal Business Name): SEAN KELLY COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1711 ERLEN RD
ELKINS PARK PA
19027-1062
US

IV. Provider business mailing address

1711 ERLEN RD
ELKINS PARK PA
19027-1062
US

V. Phone/Fax

Practice location:
  • Phone: 215-589-9970
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: SEAN STEPHEN KELLY
Title or Position: OWNER
Credential: LPC
Phone: 215-589-9970