Provider Demographics
NPI:1376807826
Name:MACEIRA, KAITLYN ELENA (LMHC, CASAC)
Entity Type:Individual
Prefix:
First Name:KAITLYN
Middle Name:ELENA
Last Name:MACEIRA
Suffix:
Gender:F
Credentials:LMHC, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 ADAMS ST
Mailing Address - Street 2:APT 11E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2858
Mailing Address - Country:US
Mailing Address - Phone:914-400-5447
Mailing Address - Fax:
Practice Address - Street 1:235 ADAMS ST
Practice Address - Street 2:APT 11E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2858
Practice Address - Country:US
Practice Address - Phone:914-400-5447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-29
Last Update Date:2014-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006304101YM0800X
NY29295101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)