Mindy Elizabeth Black-Kelly, LCSW-C
Individual provider Active NPI Clinical Social Worker · Cambridge, MD
NPI 1962779496 · NPPES record last updated Nov 29, 2011
Key facts
- NPI
- 1962779496
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 10739 (MD)
- Practice address
- 3 Cedar St
Cambridge, MD 21613-2362 - Phone
- (410) 228-4368
- NPI assigned
- Nov 29, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10739 | MD | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10739 | MD | Yes |
Addresses
Primary practice location
3 Cedar St
Cambridge, MD 21613-2362
Mailing address
3 Cedar St
Cambridge, MD 21613-2362
Phone (410) 228-4368
Other providers in Cambridge, MD
- Donna Lenore Beitel
- Roshni Bhatt
- Ankit Bhojawala
- BHW of Cambridge
- Jeff Biele
- Blackwater Medical Associates, LLC
- Blackwater Medical Associates, LLC
- Blackwater Wellness, LLC
- Asiha Blake
- Katie Bokulic
All providers in Cambridge, MD · Clinical Social Worker in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.