Provider Demographics
NPI:1093918690
Name:INSELMANN, KELLY BETH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KELLY
Middle Name:BETH
Last Name:INSELMANN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1903 SAN JUAN DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78733-1635
Mailing Address - Country:US
Mailing Address - Phone:512-586-2121
Mailing Address - Fax:
Practice Address - Street 1:1310 S 1ST ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-3061
Practice Address - Country:US
Practice Address - Phone:512-586-2121
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX327291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical