Provider Demographics
NPI:1508737677
Name:KELBY, EMERSON THOMAS (LICSW)
Entity type:Individual
Prefix:
First Name:EMERSON
Middle Name:THOMAS
Last Name:KELBY
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 PIKE HILL RD
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:NH
Mailing Address - Zip Code:03241-7537
Mailing Address - Country:US
Mailing Address - Phone:607-643-5245
Mailing Address - Fax:
Practice Address - Street 1:103 PIKE HILL RD
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:NH
Practice Address - Zip Code:03241-7537
Practice Address - Country:US
Practice Address - Phone:607-643-5245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-13
Last Update Date:2025-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH52971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical