Provider Demographics
NPI:1992357420
Name:PARSONS, KELLY A
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:A
Last Name:PARSONS
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:PARSONS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2900 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21211-2706
Mailing Address - Country:US
Mailing Address - Phone:443-681-9722
Mailing Address - Fax:
Practice Address - Street 1:2900 CHESTNUT AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21211-2706
Practice Address - Country:US
Practice Address - Phone:410-681-9722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD05783103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist