Provider Demographics
NPI:1295952752
Name:KELSEY, KIMBERLY FRAZIER (MASTER SOCIAL WORK)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:FRAZIER
Last Name:KELSEY
Suffix:
Gender:F
Credentials:MASTER SOCIAL WORK
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 17
Mailing Address - Street 2:
Mailing Address - City:OIL SPRINGS
Mailing Address - State:KY
Mailing Address - Zip Code:41238-0017
Mailing Address - Country:US
Mailing Address - Phone:606-886-1970
Mailing Address - Fax:
Practice Address - Street 1:5230 KY ROUTE 321
Practice Address - Street 2:SUITE 8
Practice Address - City:PRESTONSBURG
Practice Address - State:KY
Practice Address - Zip Code:41653-9168
Practice Address - Country:US
Practice Address - Phone:606-886-1970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical