Individual
COLLEEN KEENAN CAMPO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LMHC
Contact information
Practice address
180 E 79TH ST, NEW YORK, NY 10021-0437
(212) 744-3700
Mailing address
350 E 82ND ST APT 4L, NEW YORK, NY 10028-4912
(312) 771-0790
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
000485-1
NY
106H00000X
Marriage & Family Therapist
Primary
000485-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000485-1
STATE LICENSE NUMBER
NY
Enumeration date
05/15/2007
Last updated
09/11/2025
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