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NPI Code Detail

MEDICARE: KELSEY MAE HIDER LCSW

MEDICARE:   KELSEY MAE HIDER  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
11041C0700XClinical Social Worker149.031899IL

General Provider Information

NPI Number : 1417881913
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY MAE HIDER LCSW
Provider Business Mailing Address
First Line : 9350 N COUNTY ROAD 625 E
Second Line :
City : SEYMOUR
State : IN
Zip : 47274-9145
Country : US
Telephone Number : 815-508-0590
Fax Number :
Provider Business Practice Location Address
First Line : 3309 CLAFLIN RD
Second Line :
City : MANHATTAN
State : KS
Zip : 66503-2520
Country : US
Telephone Number : 815-508-0590
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2026
Last Update Date : 06/10/2026

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Directions to “ KELSEY MAE HIDER LCSW” Practice Location

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