Provider Demographics
NPI:1437925468
Name:CANNAMELA, KELSEY ELIZABETH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:ELIZABETH
Last Name:CANNAMELA
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:939 RIDGE RD # 2B
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08852-3200
Mailing Address - Country:US
Mailing Address - Phone:609-497-3936
Mailing Address - Fax:
Practice Address - Street 1:939 RIDGE RD # 2B
Practice Address - Street 2:
Practice Address - City:MONMOUTH JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08852-3200
Practice Address - Country:US
Practice Address - Phone:609-497-3936
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-30
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician