Provider Demographics
NPI:1982850103
Name:KELLEY, VELEA RENEE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:VELEA
Middle Name:RENEE
Last Name:KELLEY
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:DOWELL
Mailing Address - State:MD
Mailing Address - Zip Code:20629-0152
Mailing Address - Country:US
Mailing Address - Phone:410-231-0488
Mailing Address - Fax:410-449-6171
Practice Address - Street 1:225 TOWN SQUARE DR
Practice Address - Street 2:BOX 1550
Practice Address - City:LUSBY
Practice Address - State:MD
Practice Address - Zip Code:20657-6534
Practice Address - Country:US
Practice Address - Phone:410-231-0488
Practice Address - Fax:410-449-6171
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2013-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD148251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical