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NPI Code Detail

MEDICARE: DR. KELSEY ELIZABETH CANNAMELA PSYD

MEDICARE: DR. KELSEY ELIZABETH CANNAMELA PSYD
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
1106S00000XBehavior Technician
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1437925468
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELSEY ELIZABETH CANNAMELA PSYD
Provider Business Mailing Address
First Line : 939 RIDGE RD # 2B
Second Line :
City : MONMOUTH JUNCTION
State : NJ
Zip : 08852-3200
Country : US
Telephone Number : 609-497-3936
Fax Number :
Provider Business Practice Location Address
First Line : 939 RIDGE RD # 2B
Second Line :
City : MONMOUTH JUNCTION
State : NJ
Zip : 08852-3200
Country : US
Telephone Number : 609-497-3936
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2023
Last Update Date : 11/30/2023

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