MR. ETHAN A. KELLY MSW
NPI 1033414313
Social Worker - Clinical in Old Saybrook, CT

Active since January 19, 2011
263 MAIN ST, OLD SAYBROOK, CT 06475(860) 395-6380(860) 395-6382 Get Directions Write a Review

NPPES record last updated: April 26, 2011. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Mr. Ethan A. Kelly Msw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. ETHAN A. KELLY MSW (NPI 1033414313) is an individual clinical provider in Old Saybrook, Connecticut and active in the NPI registry since January 2011.

NPPES Registry Identity

NPI1033414313
Entity TypeIndividualMale
Primary Taxonomy1041C0700X
Provider Legal NameMR. ETHAN A. KELLYCredential: MSW
Location Address263 MAIN STOld Saybrook, CT 06475-2326
Mailing Address263 Main StOld Saybrook, CT 06475-2326 · (860) 395-6380 · Fax (860) 395-6382
Fax(860) 395-6382
Sole ProprietorNo
Enumeration DateJanuary 19, 2011
Last NPPES UpdateApril 26, 2011
NPI 1033414313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers
Taxonomy Code1041C0700X
Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

263 MAIN ST, Old Saybrook, CT 06475

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dental Hygienist
263 MAIN ST
OLD SAYBROOK, CT 06475
Psychologist
263 MAIN ST, SUITE 304
OLD SAYBROOK, CT 06475
Community/Behavioral Health
263 MAIN ST, SUITE 304
OLD SAYBROOK, CT 06475
Social Worker (Clinical)
263 MAIN ST
OLD SAYBROOK, CT 06475
Advanced Practice Midwife
263 MAIN ST
OLD SAYBROOK, CT 06475
Counselor (Professional)
263 MAIN ST, SUITE 304
OLD SAYBROOK, CT 06475
Nurse Practitioner (Women's Health)
263 MAIN ST
OLD SAYBROOK, CT 06475
Counselor (Addiction (Substance Use Disorder))
263 MAIN ST, 301
OLD SAYBROOK, CT 06475

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Kelly's NPI number?

The NPI number for Ethan Kelly is 1033414313. It was assigned to this individual provider in the NPPES registry on January 19, 2011.

Where is Ethan Kelly located?

Ethan Kelly practices at 263 Main St, Old Saybrook, CT 06475. The listed phone number is (860) 395-6380.

What is Ethan Kelly's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

When was this NPI record last updated?

The NPPES record for Ethan Kelly was last updated on April 26, 2011. NPI Profile syncs with the weekly NPPES data releases published by CMS.