Provider Demographics
NPI:1922707009
Name:UTZ, KELSIE FAITH (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:KELSIE
Middle Name:FAITH
Last Name:UTZ
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 1:3141 ELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-2922
Mailing Address - Country:US
Mailing Address - Phone:540-539-8290
Mailing Address - Fax:
Practice Address - Street 1:4906 RADFORD AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-3512
Practice Address - Country:US
Practice Address - Phone:804-354-5532
Practice Address - Fax:804-354-5516
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040143631041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical