Provider Demographics
NPI:1336637362
Name:MAIORANA, KIERAN PATRICK (LPC)
Entity Type:Individual
Prefix:
First Name:KIERAN
Middle Name:PATRICK
Last Name:MAIORANA
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 YORK ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5602
Mailing Address - Country:US
Mailing Address - Phone:203-785-6862
Mailing Address - Fax:203-785-7517
Practice Address - Street 1:98 YORK ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5602
Practice Address - Country:US
Practice Address - Phone:203-530-5396
Practice Address - Fax:203-785-7517
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT03429101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional