Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kelly Jean Wise, LCSW

Individual provider Clinical Social Worker · NPI 1073800108

Kelly Jean Wise, LCSW is a Clinical Social Worker in Brooklyn, New York. Practices as a sole proprietor. Licensed in New York.

Licensed in
NY
In the registry since
2011
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

60 Plaza St E Ste 1G
Brooklyn, NY 11238-5025
Phone: (917) 822-5045
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 73-07699 (NY)

Record details

NPI number1073800108
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedJuly 10, 2011
Last updated in NPPESMarch 14, 2017

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