Provider Demographics
NPI:1720332398
Name:GEARY, KELLY ANN (LCSW, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:ANN
Last Name:GEARY
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3239 HAVEN AVENUE
Mailing Address - Street 2:
Mailing Address - City:OCEAN CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08226
Mailing Address - Country:US
Mailing Address - Phone:609-465-7788
Mailing Address - Fax:609-465-2005
Practice Address - Street 1:223 S. MAIN STREET
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-2240
Practice Address - Country:US
Practice Address - Phone:609-465-7788
Practice Address - Fax:609-465-2005
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00261900101YA0400X
NJ44SC05390500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)