Provider Demographics
NPI:1427600402
Name:LOVEJOY, KELSI MARIE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:KELSI
Middle Name:MARIE
Last Name:LOVEJOY
Suffix:
Gender:F
Credentials:MSW, LCSW
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 122
Mailing Address - Street 2:
Mailing Address - City:PINEDALE
Mailing Address - State:WY
Mailing Address - Zip Code:82941-0122
Mailing Address - Country:US
Mailing Address - Phone:307-360-7998
Mailing Address - Fax:
Practice Address - Street 1:5 MAGNOLA ST
Practice Address - Street 2:
Practice Address - City:PINEDALE
Practice Address - State:WY
Practice Address - Zip Code:82941
Practice Address - Country:US
Practice Address - Phone:307-734-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-10
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYLCSW-1406OtherSTATE OF WYOMING MENTAL HEALTH PROFESSIONAL LICENSING BOARD
WYPCSW-855OtherPROVISIONAL CLINICAL SOCIAL WORKER