Provider Demographics
NPI:1073823498
Name:HARRISON, KAYDIAN N (MSW)
Entity Type:Individual
Prefix:
First Name:KAYDIAN
Middle Name:N
Last Name:HARRISON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 FOUNTAIN ST
Mailing Address - Street 2:APT. 1H2
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1946
Mailing Address - Country:US
Mailing Address - Phone:203-559-8910
Mailing Address - Fax:
Practice Address - Street 1:160 FOUNTAIN ST
Practice Address - Street 2:APT. 1H2
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1946
Practice Address - Country:US
Practice Address - Phone:203-559-8910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-19
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical