Provider Demographics
NPI:1811466857
Name:NIVER, KELLEY JEANINE (LICSW)
Entity type:Individual
Prefix:MS
First Name:KELLEY
Middle Name:JEANINE
Last Name:NIVER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 PLEASANT ST
Mailing Address - Street 2:
Mailing Address - City:WEST SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01089-3163
Mailing Address - Country:US
Mailing Address - Phone:413-739-1565
Mailing Address - Fax:
Practice Address - Street 1:51 E MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:MA
Practice Address - Zip Code:01085-1801
Practice Address - Country:US
Practice Address - Phone:413-846-5231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1179731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical