Provider Demographics
NPI:1740024553
Name:MCCARTNEY, KELSEY ELAINE
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ELAINE
Last Name:MCCARTNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 CLEVELAND PL
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-6326
Mailing Address - Country:US
Mailing Address - Phone:516-506-2088
Mailing Address - Fax:
Practice Address - Street 1:54 CLEVELAND PL
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-6326
Practice Address - Country:US
Practice Address - Phone:516-506-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-25
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst