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NPI Code Detail

MEDICARE: KELSEY GLENN REEDER LCSW-R

MEDICARE: KELSEY GLENN REEDER LCSW-R
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 Worker087949NY
21041C0700XClinical Social WorkerR087949NY

General Provider Information

NPI Number : 1831645175
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY GLENN REEDER LCSW-R
Provider Business Mailing Address
First Line : 1255 AMSTERDAM AVE FL 9
Second Line :
City : NEW YORK
State : NY
Zip : 10027-5927
Country : US
Telephone Number : 347-560-0216
Fax Number :
Provider Business Practice Location Address
First Line : 1255 AMSTERDAM AVE FL 9
Second Line :
City : NEW YORK
State : NY
Zip : 10027-5927
Country : US
Telephone Number : 347-560-0216
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2016
Last Update Date : 05/13/2022

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