Provider Demographics
NPI:1245828821
Name:KWIECIEN, KATELYNN ANN (LCSW)
Entity type:Individual
Prefix:
First Name:KATELYNN
Middle Name:ANN
Last Name:KWIECIEN
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 1:6 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-2938
Mailing Address - Country:US
Mailing Address - Phone:518-577-8397
Mailing Address - Fax:
Practice Address - Street 1:100 WEST AVE
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-6083
Practice Address - Country:US
Practice Address - Phone:518-462-6531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical