Provider Demographics
NPI:1407566029
Name:MORRISSEY, KELLY
Entity Type:Individual
Prefix:MISS
First Name:KELLY
Middle Name:
Last Name:MORRISSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6093
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-6193
Mailing Address - Country:US
Mailing Address - Phone:603-288-2207
Mailing Address - Fax:
Practice Address - Street 1:94 N ELM ST STE 206
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-1641
Practice Address - Country:US
Practice Address - Phone:413-437-9294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool