Provider Demographics
NPI:1275741795
Name:KEADY, DARCY A (MS, LMFT)
Entity Type:Individual
Prefix:
First Name:DARCY
Middle Name:A
Last Name:KEADY
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 SHIRE OAKS DR
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-1552
Mailing Address - Country:US
Mailing Address - Phone:585-385-0802
Mailing Address - Fax:
Practice Address - Street 1:1400 WESTFALL RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-2771
Practice Address - Country:US
Practice Address - Phone:585-472-0951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000225106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist