Provider Demographics
NPI:1689973604
Name:KELLY, DENA ELIZABETH (MA, LPC, BCBA, BSL)
Entity type:Individual
Prefix:MRS
First Name:DENA
Middle Name:ELIZABETH
Last Name:KELLY
Suffix:
Gender:
Credentials:MA, LPC, BCBA, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1844 E RIDGE PIKE STE 108
Mailing Address - Street 2:
Mailing Address - City:ROYERSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19468-2832
Mailing Address - Country:US
Mailing Address - Phone:484-898-3333
Mailing Address - Fax:
Practice Address - Street 1:1844 E RIDGE PIKE STE 108
Practice Address - Street 2:
Practice Address - City:ROYERSFORD
Practice Address - State:PA
Practice Address - Zip Code:19468-2832
Practice Address - Country:US
Practice Address - Phone:484-898-3333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-16
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC-007616101YM0800X
PABH005109103K00000X
103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty