Provider Demographics
NPI:1932826799
Name:AHERN, KATHLEEN (LPC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:AHERN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 OLD HICKORY RD
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CT
Mailing Address - Zip Code:06477-1826
Mailing Address - Country:US
Mailing Address - Phone:203-506-4928
Mailing Address - Fax:
Practice Address - Street 1:131 OLD HICKORY RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-1826
Practice Address - Country:US
Practice Address - Phone:203-506-4928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2726101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health