Provider Demographics
NPI:1467801993
Name:ROWELL, KELLEY MAGEN (MSW)
Entity Type:Individual
Prefix:
First Name:KELLEY
Middle Name:MAGEN
Last Name:ROWELL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KELLEY
Other - Middle Name:MAGEN
Other - Last Name:ROWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:46 BROOKLAND ST
Mailing Address - Street 2:APT. 3
Mailing Address - City:BROOKLAND
Mailing Address - State:AR
Mailing Address - Zip Code:72417-8877
Mailing Address - Country:US
Mailing Address - Phone:870-530-4121
Mailing Address - Fax:
Practice Address - Street 1:1217 STONE ST
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-4520
Practice Address - Country:US
Practice Address - Phone:870-972-1268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker