Provider Demographics
NPI:1275209884
Name:SMITH, KELSEY DELANA (LGSW)
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:DELANA
Last Name:SMITH
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:MS
Other - First Name:KELSEY
Other - Middle Name:DELANA
Other - Last Name:ADKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:200 VETERANS AVE
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-6444
Mailing Address - Country:US
Mailing Address - Phone:304-255-2121
Mailing Address - Fax:
Practice Address - Street 1:200 VETERANS AVE
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-6444
Practice Address - Country:US
Practice Address - Phone:304-255-2121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVBP00944760104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker