Individual
KARLY REGINA KEATING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
226 DIXWELL AVENUE, NORTHSIDE, NEW HAVEN, CT 06511-3456
(203) 503-3470
(203) 503-3478
Mailing address
400 COLUMBUS AVENUE, CREDENTIALING SPECIALIST, NEW HAVEN, CT 06519-1233
(203) 503-3000
(203) 503-6515
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
11936
CT
Other
Enumeration date
08/02/2019
Last updated
12/16/2021
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