Provider Demographics
NPI:1629830930
Name:SANTOS, KELIN (MSW-LMHP-S)
Entity Type:Individual
Prefix:MRS
First Name:KELIN
Middle Name:
Last Name:SANTOS
Suffix:
Gender:F
Credentials:MSW-LMHP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7176 SYDNOR LN
Mailing Address - Street 2:
Mailing Address - City:MECHANICSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:23111-5019
Mailing Address - Country:US
Mailing Address - Phone:646-708-3159
Mailing Address - Fax:
Practice Address - Street 1:7176 SYDNOR LN
Practice Address - Street 2:
Practice Address - City:MECHANICSVILLE
Practice Address - State:VA
Practice Address - Zip Code:23111-5019
Practice Address - Country:US
Practice Address - Phone:646-708-3159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09060093411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical