Provider Demographics
NPI:1447708748
Name:ATKINSON, KELSEY
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 E RIVERSIDE DR.
Mailing Address - Street 2:ST. 3A
Mailing Address - City:ST. GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7051
Mailing Address - Country:US
Mailing Address - Phone:018-980-2566
Mailing Address - Fax:
Practice Address - Street 1:491 E RIVERSIDE DR.
Practice Address - Street 2:ST. 3A
Practice Address - City:ST. GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7051
Practice Address - Country:US
Practice Address - Phone:018-980-2566
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-14
Last Update Date:2024-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12896584-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical