Provider Demographics
NPI:1801553532
Name:MCGRATH, KELLY (MSW, LSW, CSW)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:MSW, LSW, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 MAIN ST APT 15B
Mailing Address - Street 2:
Mailing Address - City:SPOTSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08884-2328
Mailing Address - Country:US
Mailing Address - Phone:973-945-9651
Mailing Address - Fax:
Practice Address - Street 1:289 MAIN ST APT 15B
Practice Address - Street 2:
Practice Address - City:SPOTSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08884-2328
Practice Address - Country:US
Practice Address - Phone:973-945-9651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-17
Last Update Date:2021-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM44SL066760001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical