Mckeithen, John

Mckeithen, John is an individual health care provider with primary practice located at 495 Congress Ave , New Haven CT 06519-1312. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder). Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is his primary health care specialty. Mckeithen, John can be contacted via phone (203) 781-4600.

Contact Information

Primary practice address
495 Congress Ave New Haven CT 06519-1312
Phone: (203) 781-4600
Fax: (203) 781-4624
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 001918 Connecticut
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 00631 Connecticut

Profile Details

NPI number 1770772576
LBN Legal business name Mckeithen, John
Credentials M.ED, LPC, LADC.
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 17th, 2007
Last updated Jan 24th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770772576 NPPES
Connecticut MEDICAID 004082260
Connecticut MEDICAID 0080494436
Connecticut MEDICAID 008001325
Connecticut MEDICAID 008022622

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