Provider Demographics
NPI:1295481158
Name:KEY COUNSELING LLC
Entity type:Organization
Organization Name:KEY COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SAMANTHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PELKEY-FLOCK
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:203-499-7348
Mailing Address - Street 1:PO BOX 2305
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06457-0033
Mailing Address - Country:US
Mailing Address - Phone:203-499-7348
Mailing Address - Fax:
Practice Address - Street 1:764 E MAIN ST APT B
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-2921
Practice Address - Country:US
Practice Address - Phone:203-499-7348
Practice Address - Fax:833-301-2087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-01
Last Update Date:2022-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1316556239Medicaid