Provider Demographics
NPI:1922207646
Name:KEELTY, KATE A (LMHC, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:KATE
Middle Name:A
Last Name:KEELTY
Suffix:
Gender:F
Credentials:LMHC, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 WATER ST
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:RI
Mailing Address - Zip Code:02871
Mailing Address - Country:US
Mailing Address - Phone:401-344-9027
Mailing Address - Fax:
Practice Address - Street 1:575 EAST MAIN RD
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:RI
Practice Address - Zip Code:02842
Practice Address - Country:US
Practice Address - Phone:401-344-9027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-12
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP01353235Z00000X
101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty