Healthcare Provider Details

I. General information

NPI: 1154230605
Provider Name (Legal Business Name): GRACE ANN KIELY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 TERRY DR STE 7AND15
NEWTOWN PA
18940-1838
US

IV. Provider business mailing address

139 BLAKE AVE
JENKINTOWN PA
19046-4208
US

V. Phone/Fax

Practice location:
  • Phone: 267-450-4800
  • Fax: 267-450-4801
Mailing address:
  • Phone: 267-450-4800
  • Fax: 267-450-4801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC020959
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: