Provider Demographics
NPI:1609947712
Name:KELEN, JOYCE ARLENE (LCSW)
Entity Type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ARLENE
Last Name:KELEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 M ST
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84103-3854
Mailing Address - Country:US
Mailing Address - Phone:801-322-3117
Mailing Address - Fax:801-363-9022
Practice Address - Street 1:925 E 900 S
Practice Address - Street 2:SUITE 26
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84105-1401
Practice Address - Country:US
Practice Address - Phone:801-537-7523
Practice Address - Fax:801-363-9022
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT119968-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
UTR60882Medicare UPIN