Provider Demographics
NPI:1386037430
Name:MCCREIGHT, KELSEY (MSW, LSW)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:MCCREIGHT
Suffix:
Gender:F
Credentials:MSW, LSW
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:
Other - Last Name:BEACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:785 5TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-709-6529
Practice Address - Street 1:1886 ROHRERSTOWN RD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-2322
Practice Address - Country:US
Practice Address - Phone:717-735-1920
Practice Address - Fax:717-735-1921
Is Sole Proprietor?:No
Enumeration Date:2015-03-13
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0198601041C0700X
PASW132163104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103743058Medicaid
13642570OtherCAQH
PACW019860OtherSTATE LICENSE