Nichole Suzanne Kelso, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

Q1-0012480 Issued in DE

Practice address

932 Eddystone Ave
Eddystone, PA 19022-1412

Phone

(215) 833-4678

NPI assigned

Dec 21, 2024

Last updated

Dec 21, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1734739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734739200000",
    "number": "1871301960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "932 EDDYSTONE AVE",
            "city": "EDDYSTONE",
            "state": "PA",
            "postal_code": "190221412",
            "telephone_number": "215-833-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 EDDYSTONE AVE",
            "city": "EDDYSTONE",
            "state": "PA",
            "postal_code": "190221412",
            "telephone_number": "215-833-4678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELSO",
        "first_name": "NICHOLE",
        "middle_name": "SUZANNE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-21",
        "last_updated": "2024-12-21",
        "certification_date": "2024-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0012480",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Eddystone, PA
• Providers in Eddystone, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.