Provider Demographics
NPI:1891240776
Name:CLAYTON-FEARON, KEISHA (LCSW)
Entity Type:Individual
Prefix:
First Name:KEISHA
Middle Name:
Last Name:CLAYTON-FEARON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KEISHA
Other - Middle Name:N
Other - Last Name:CLAYTON-FEARON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:83 WOOSTER HEIGHTS RD.
Mailing Address - Street 2:SUITE 125
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-7005
Mailing Address - Country:US
Mailing Address - Phone:888-297-4639
Mailing Address - Fax:888-297-4639
Practice Address - Street 1:83 WOOSTER HEIGHTS RD.
Practice Address - Street 2:SUITE 125
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-7005
Practice Address - Country:US
Practice Address - Phone:203-690-0260
Practice Address - Fax:888-297-4639
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-19
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT58.0104201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical