Provider Demographics
NPI:1295965010
Name:JEANTY, KAITY (PSYD)
Entity type:Individual
Prefix:DR
First Name:KAITY
Middle Name:
Last Name:JEANTY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 SCHOOL ST APT 16
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3125
Mailing Address - Country:US
Mailing Address - Phone:516-457-8006
Mailing Address - Fax:
Practice Address - Street 1:446 BLAKE ST STE 200
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1286
Practice Address - Country:US
Practice Address - Phone:203-387-9400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist