Provider Demographics
NPI:1023104833
Name:KELLY, EMILY HUFFMAN (BA, MSW)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:HUFFMAN
Last Name:KELLY
Suffix:
Gender:F
Credentials:BA, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 DERBY ST STE 15
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3718
Mailing Address - Country:US
Mailing Address - Phone:617-827-7395
Mailing Address - Fax:781-740-8212
Practice Address - Street 1:62 DERBY ST STE 15
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-3718
Practice Address - Country:US
Practice Address - Phone:617-827-7395
Practice Address - Fax:781-740-8212
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2025-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALICSW1153881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical