Terrell L. Kelly is a Clinical in Driggs, Idaho. Terrell L. Kelly practices all healthcare services and medical treatments related to Clinical. The NPI Number for Terrell L. Kelly is 1417015876. The last update date is 2007-07-08.
Terrell L. Kelly's current location address is 120 E Howard St, Driggs, Idaho. You can contact this provider via phone number 2083546317. The mailing address for Terrell L. Kelly is 120 E Howard St, Driggs, Idaho. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Terrell L. Kelly |
|---|---|
| Address | 120 E Howard St, Driggs, Idaho |
| Phone Number | 2083546317 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | LCSW |
NPI Number Detail
| NPI Number | 1417015876 |
|---|---|
| Provider Enumeration Date | 2006-12-05 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 120 E Howard St |
|---|---|
| City | Driggs |
| State | Idaho (ID) |
| Post Code | 834225112 |
| Phone Number | 2083546317 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | LCSW-431 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10015891 | ID | BLUE SHIELD | |
| L4314 | ID | BLUE CROSS |
Post Comment/ Review Below
What is the unique identification code assigned to Terrell L. Kelly by the Centers for Medicare & Medicaid Services?
The Terrell L. Kelly has been issued the NPI (National Provider Identifier) 1417015876. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Terrell L. Kelly is physically located?
The Terrell L. Kelly is situated at the following address: 120 E Howard St, Driggs, ID 834225112.
What is Terrell L. Kelly's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Terrell L. Kelly is Clinical, and the taxonomy code that classifies this field of practice is 1041C0700X.
When was the Terrell L. Kelly's 1417015876 issued?
The Terrell L. Kelly's 1417015876 was issued on 2006-12-05.
As of what date were the details related to Terrell L. Kelly most recently updated or revised?
The information pertaining to Terrell L. Kelly, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-08.
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