Provider Demographics
NPI:1982440210
Name:KESSELLY-KPANABOM, ZINNEH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ZINNEH
Middle Name:
Last Name:KESSELLY-KPANABOM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ZINNEH
Other - Middle Name:K
Other - Last Name:KESSELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2010 W CHESTER PIKE STE 314
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2737
Mailing Address - Country:US
Mailing Address - Phone:610-892-3800
Mailing Address - Fax:
Practice Address - Street 1:2010 W CHESTER PIKE STE 314
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2737
Practice Address - Country:US
Practice Address - Phone:610-892-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-05
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW025310104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker