Provider Demographics
NPI:1063474732
Name:KIELY, KAREN DURST (PHD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:DURST
Last Name:KIELY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 LE ROI RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15208-2717
Mailing Address - Country:US
Mailing Address - Phone:412-241-2184
Mailing Address - Fax:412-241-6769
Practice Address - Street 1:5889 FORBES AVE
Practice Address - Street 2:SUITE 320, FORBES/SHADY COMMONS
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15217-1660
Practice Address - Country:US
Practice Address - Phone:412-421-7155
Practice Address - Fax:412-241-6769
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS004591L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA058120OtherPROVIDER ID