Provider Demographics
NPI:1588438527
Name:MONROE, KELSEY NICHOLE (LMSW)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:NICHOLE
Last Name:MONROE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 SPEARMAN RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:SC
Mailing Address - Zip Code:29697-9136
Mailing Address - Country:US
Mailing Address - Phone:864-934-9216
Mailing Address - Fax:
Practice Address - Street 1:102 BUFORD AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3363
Practice Address - Country:US
Practice Address - Phone:864-261-9506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-09
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12645104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker