Provider Demographics
NPI:1609033281
Name:MCLAUGHLIN, KELLY A (LPC)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:A
Last Name:MCLAUGHLIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FERNWOOD ST
Mailing Address - Street 2:SUITE A -12
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-2321
Mailing Address - Country:US
Mailing Address - Phone:860-970-3402
Mailing Address - Fax:
Practice Address - Street 1:146 ELM ST
Practice Address - Street 2:SUITE A-12
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-2808
Practice Address - Country:US
Practice Address - Phone:860-970-3402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-21
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001693101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004215308Medicaid