Provider Demographics
NPI:1235547886
Name:CHIARELLO, KELLI (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KELLI
Middle Name:
Last Name:CHIARELLO
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 1:201 HOOPER AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-7671
Mailing Address - Country:US
Mailing Address - Phone:732-232-2802
Mailing Address - Fax:
Practice Address - Street 1:201 HOOPER AVE STE 4
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7671
Practice Address - Country:US
Practice Address - Phone:732-232-2802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC055126001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical