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MS. KELLY GRAY EZICKSON LICSW
NPI 1043284839
Social Worker in Quincy, MA

Active since February 16, 2006
29 COTTAGE AVE SUITE 11, QUINCY, MA 02169(617) 472-9838(617) 472-6269 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

About Ms. Kelly Gray Ezickson Licsw NPPES

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

MS. KELLY GRAY EZICKSON LICSW (NPI 1043284839) is an individual social worker in Quincy, Massachusetts, licensed in Massachusetts (1020756) and active in the NPI registry since February 2006.

NPPES Registry Identity

NPI1043284839
Entity TypeIndividualFemale
Primary Taxonomy104100000X
Provider Legal NameMS. KELLY GRAY EZICKSONCredential: LICSW
Location Address29 COTTAGE AVE SUITE 11Quincy, MA 02169
Mailing Address29 Cottage Ave Suite 11Quincy, MA 02169 · (617) 472-9838 · Fax (617) 472-6269
Phone(617) 472-9838
Fax(617) 472-6269
Sole ProprietorNo
Enumeration DateFebruary 16, 2006
Last NPPES UpdateJuly 13, 2026
✔ NPI 1043284839 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial WorkerBehavioral Health & Social Service Providers
Taxonomy Code104100000X
License✔ Licensed in MA · 1020756
Definition
A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public.
29 COTTAGE AVE SUITE 11, Quincy, MA 02169
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Other Identifiers 2

MedicaidRA P30158MA
OtherP06289MA · Bcbs

Other Providers at the Same Location NPPES

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

DEBORAH G ROUSLIN LICSW
Social Worker
29 COTTAGE AVE SUITE 11
QUINCY, MA 02169
Norfolk County (617) 472-9838

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 Kelly Ezickson's NPI number?

The NPI number for Kelly Ezickson is 1043284839. It was assigned to this individual provider in the NPPES registry on February 16, 2006.

Where is Kelly Ezickson located?

Kelly Ezickson practices at 29 Cottage Ave Suite 11, Quincy, MA 02169. The listed phone number is (617) 472-9838.

What is Kelly Ezickson's specialty?

The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.

When was this NPI record last updated?

The NPPES record for Kelly Ezickson was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.