Provider Demographics
NPI:1982440210
Name:KESSELLY-KPANABOM, ZINNEH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ZINNEH
Middle Name:
Last Name:KESSELLY-KPANABOM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ZINNEH
Other - Middle Name:K
Other - Last Name:KESSELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:529 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19023-3114
Mailing Address - Country:US
Mailing Address - Phone:267-670-0259
Mailing Address - Fax:
Practice Address - Street 1:529 S 3RD ST
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-3114
Practice Address - Country:US
Practice Address - Phone:267-670-0259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-05
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA138599104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker