Provider Demographics
NPI:1497034821
Name:KET-YING, KERI-ANN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KERI-ANN
Middle Name:
Last Name:KET-YING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-2915
Mailing Address - Country:US
Mailing Address - Phone:718-875-1473
Mailing Address - Fax:
Practice Address - Street 1:105 JOHNSON ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-2915
Practice Address - Country:US
Practice Address - Phone:718-875-1473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-16
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078333-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical