Provider Demographics
NPI:1841858222
Name:KT PSYCHOTHERAPY LLC
Entity type:Organization
Organization Name:KT PSYCHOTHERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:KENA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:732-619-1811
Mailing Address - Street 1:16 ALLISON DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4474
Mailing Address - Country:US
Mailing Address - Phone:732-619-1811
Mailing Address - Fax:
Practice Address - Street 1:16 ALLISON DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4474
Practice Address - Country:US
Practice Address - Phone:732-619-1811
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-31
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health