Provider Demographics
NPI:1457579583
Name:MCCLOSKEY, KATHY A (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHY
Middle Name:A
Last Name:MCCLOSKEY
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 1:26 GUERNSEY ROAD
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06002
Mailing Address - Country:US
Mailing Address - Phone:860-243-0373
Mailing Address - Fax:
Practice Address - Street 1:200 BLOOMFIELD AVENUE
Practice Address - Street 2:UNIVERSITY OF HARTFORD
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06117
Practice Address - Country:US
Practice Address - Phone:860-768-4442
Practice Address - Fax:860-768-4814
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002466103TC0700X
OH5582103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical