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General NPI Number Information
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NPI Number | 1801355540
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Entity Type | Individual
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Provider Name | KEVIN ALLAN KELSEY LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/12/2019
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Last Update Date | 06/27/2025
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Provider Practice Location Address
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Address Line | 7010 S UNION AVE
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City | CHICAGO
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State | IL
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Zip | 60621-2418
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Country | US
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Telephone | 708-925-4523
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Fax |
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Provider Business Mailing Address
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Address Line | 14 EASLEY CT
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City | NAPA
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State | CA
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Zip | 94558-2264
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Country | US
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Telephone | 630-453-0413
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.021058
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW342112
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License Number State | CA
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