Provider Demographics
NPI:1487101507
Name:KRASNOW, MEGHAN K (PSYD)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:K
Last Name:KRASNOW
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 1:32 SEYMOUR ST
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106-3321
Mailing Address - Country:US
Mailing Address - Phone:860-972-5945
Mailing Address - Fax:
Practice Address - Street 1:32 SEYMOUR ST
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106-3321
Practice Address - Country:US
Practice Address - Phone:860-972-5945
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004362103TC0700X, 103TE1100X, 103TH0004X, 103TC1900X
103TC1900X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TE1100XBehavioral Health & Social Service ProvidersPsychologistExercise & Sports
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program