Provider Demographics
NPI:1578232989
Name:GRUMMERT, KELSEY (LCSWA)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:GRUMMERT
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3512 KAREN ST
Mailing Address - Street 2:
Mailing Address - City:NEW BERN
Mailing Address - State:NC
Mailing Address - Zip Code:28560-4100
Mailing Address - Country:US
Mailing Address - Phone:252-229-9632
Mailing Address - Fax:
Practice Address - Street 1:2801 NEUSE BLVD
Practice Address - Street 2:
Practice Address - City:NEW BERN
Practice Address - State:NC
Practice Address - Zip Code:28562-2838
Practice Address - Country:US
Practice Address - Phone:252-636-6007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical