Provider Demographics
NPI:1790727782
Name:ZELLEFROW, KENT
Entity Type:Individual
Prefix:MR
First Name:KENT
Middle Name:
Last Name:ZELLEFROW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1113 HAMIL RD
Mailing Address - Street 2:
Mailing Address - City:VERONA
Mailing Address - State:PA
Mailing Address - Zip Code:15147-2725
Mailing Address - Country:US
Mailing Address - Phone:412-798-8366
Mailing Address - Fax:
Practice Address - Street 1:331 SHAW AVE
Practice Address - Street 2:
Practice Address - City:MCKEESPORT
Practice Address - State:PA
Practice Address - Zip Code:15132-2918
Practice Address - Country:US
Practice Address - Phone:412-675-8850
Practice Address - Fax:412-675-8452
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2009-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0159851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical