Individual provider · Type 1 NPI

Kellie Illmensee, LCSW

Clinical Social Worker · Middletown, NJ

NPI number 1629592993 Active · reactivated Oct 14, 2022

Practice location

268 Pelican Rd
Middletown, NJ 07748-3040

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X44SC05738600 (NJ)

Clinical Social Worker: 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 interpers…

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About NPI 1629592993

Kellie Illmensee, LCSW's National Provider Identifier is 1629592993, issued on Jul 28, 2017. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Middletown, NJ. The record was last updated on Oct 16, 2025.