Provider Demographics
NPI:1669829388
Name:SIEGEL, KELSEY (LMHC; LPC)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:LMHC; LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 WALNUT HOLLOW LN
Mailing Address - Street 2:
Mailing Address - City:HOLMDEL
Mailing Address - State:NJ
Mailing Address - Zip Code:07733-1352
Mailing Address - Country:US
Mailing Address - Phone:914-316-5424
Mailing Address - Fax:
Practice Address - Street 1:4 WALNUT HOLLOW LN
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1352
Practice Address - Country:US
Practice Address - Phone:914-316-5424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-23
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007196101YM0800X
NJ37PC00609100101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health