Provider Demographics
NPI:1598376709
Name:CHILSON, KELLEY (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KELLEY
Middle Name:
Last Name:CHILSON
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 1:100 N. ACADEMY AVE
Mailing Address - Street 2:GEISINGER MEDICAL CENTER DEPARTMENT OF PSYCHIATRY
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-1335
Mailing Address - Country:US
Mailing Address - Phone:570-271-6516
Mailing Address - Fax:
Practice Address - Street 1:100 N. ACADEMY AVE
Practice Address - Street 2:GEISINGER MEDICAL CENTER DEPARTMENT OF PSYCHIATRY
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-1335
Practice Address - Country:US
Practice Address - Phone:570-271-6516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist