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NPI Code Detail

MEDICARE: KELSEY STANCLIFFE

MEDICARE: KELSEY STANCLIFFE
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
1104100000XSocial Worker14101LA
21041C0700XClinical Social WorkerDP00946256WV

General Provider Information

NPI Number : 1326583451
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY STANCLIFFE
Provider Business Mailing Address
First Line : 295 HIGH ST STE 3
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-5449
Country : US
Telephone Number : 304-363-4265
Fax Number :
Provider Business Practice Location Address
First Line : 295 HIGH ST STE 3
Second Line :
City : MORGANTOWN
State : WV
Zip : 26505-5449
Country : US
Telephone Number : 304-363-4265
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2016
Last Update Date : 09/30/2022

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Directions to “ KELSEY STANCLIFFE ” Practice Location

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