Provider Demographics
NPI:1003642141
Name:FLEMING, KELSEY GENE (LCSW)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:GENE
Last Name:FLEMING
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 1:636 STONELEDGE RD
Mailing Address - Street 2:
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16803-1255
Mailing Address - Country:US
Mailing Address - Phone:814-360-9811
Mailing Address - Fax:
Practice Address - Street 1:566 EISENHOWER RD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PARK
Practice Address - State:PA
Practice Address - Zip Code:16802-4601
Practice Address - Country:US
Practice Address - Phone:814-360-9811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-13
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0228311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical