MEDICARE: KELLY JEAN WISE LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	73-07699	NY

General Provider Information

NPI Number	:	1073800108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY JEAN WISE LCSW

Provider Business Mailing Address
First Line	:	60 PLAZA ST E
Second Line	:	1G
City	:	BROOKLYN
State	:	NY
Zip	:	11238-5025
Country	:	US
Telephone Number	:	917-822-5045
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 PLAZA ST E
Second Line	:	SUITE 1G
City	:	BROOKLYN
State	:	NY
Zip	:	11238-5025
Country	:	US
Telephone Number	:	917-822-5045
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2011
Last Update Date	:	03/14/2017

Similar Medicare Providers

1043258726 — CASCYA CHARLOT MD
Practice Location Address:

60 PLAZA ST E # 1L
BROOKLYN, NY
11238-5025

Practice Phone: 347-564-3211
Practice Fax: 347-710-1959

1932242583 — DR. DENISE LYNN MILES PSYD
Practice Location Address:

60 PLAZA ST E , SUITE 1K
BROOKLYN, NY
11238-5025

Practice Phone: 347-316-8575
Practice Fax:

1316187719 — DR. COURTNEY L LEE MD
Practice Location Address:

60 PLAZA ST E , SUITE 1L
BROOKLYN, NY
11238-5025

Practice Phone: 718-638-9222
Practice Fax: 718-857-1714

1720639909 — LISA BETH BROWN PHD, LCSW, MED
Practice Location Address:

60 PLAZA ST E
BROOKLYN, NY
11238-5025

Practice Phone: 516-639-2072
Practice Fax:

1871259044 — OLIVIA SIMONE DADDI LCSW
Practice Location Address:

60 PLAZA ST E
BROOKLYN, NY
11238-5025

Practice Phone: 347-466-9449
Practice Fax:

1447916390 — WISE THERAPY LCSW PC
Practice Location Address:

60 PLAZA ST E # BS-1
BROOKLYN, NY
11238-5025

Practice Phone: 917-822-5045
Practice Fax:

Directions to “ KELLY JEAN WISE LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.