Provider Demographics
NPI:1821497397
Name:KLOO, EMILY KATE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:KATE
Last Name:KLOO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:KATE
Other - Last Name:ROYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 RUTLEDGE RD
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1934
Mailing Address - Country:US
Mailing Address - Phone:203-596-9359
Mailing Address - Fax:203-757-9753
Practice Address - Street 1:693 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:CT
Practice Address - Zip Code:06002-2489
Practice Address - Country:US
Practice Address - Phone:860-243-6584
Practice Address - Fax:860-243-6591
Is Sole Proprietor?:No
Enumeration Date:2014-08-20
Last Update Date:2018-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT58.0096081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical