Provider Demographics
NPI:1811081862
Name:SCHWEITZER, KELLI SEMION (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KELLI
Middle Name:SEMION
Last Name:SCHWEITZER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E BALTIMORE AVE UNIT 1211
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-9998
Mailing Address - Country:US
Mailing Address - Phone:484-440-9001
Mailing Address - Fax:
Practice Address - Street 1:14 WAR TROPHY LN
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-5227
Practice Address - Country:US
Practice Address - Phone:484-440-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2021-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0142511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical