Provider Demographics
NPI:1316455785
Name:HENSLEY, KELSEY MARIE (ACSW, MSW, CATC IV)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:MARIE
Last Name:HENSLEY
Suffix:
Gender:F
Credentials:ACSW, MSW, CATC IV
Other - Prefix:MS
Other - First Name:KELSEY
Other - Middle Name:MARIE
Other - Last Name:DEVRIES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CATC III
Mailing Address - Street 1:26001 REDLANDS BLVD
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-7762
Mailing Address - Country:US
Mailing Address - Phone:909-825-7084
Mailing Address - Fax:
Practice Address - Street 1:26001 REDLANDS BLVD
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-7762
Practice Address - Country:US
Practice Address - Phone:909-825-7084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-18
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7339-R101YA0400X
RICSW033431041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)