Provider Demographics
NPI:1437794419
Name:ABBOTT, KELLEY ANNE (MSW, LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:ANNE
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MISS
Other - First Name:KELLEY
Other - Middle Name:ANNE
Other - Last Name:ADELSBERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW
Mailing Address - Street 1:155 LINDEN AVE
Mailing Address - Street 2:
Mailing Address - City:PITMAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08071-2109
Mailing Address - Country:US
Mailing Address - Phone:267-357-2260
Mailing Address - Fax:
Practice Address - Street 1:20 BRACE RD STE 202
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-2634
Practice Address - Country:US
Practice Address - Phone:856-522-4061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-13
Last Update Date:2024-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ101YP2500X
NJ44SC062949001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional