Provider Demographics
NPI:1558117952
Name:MCKEIGHAN, KATELYN ANNA (MA)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ANNA
Last Name:MCKEIGHAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3049 COUNTY ROUTE 30
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NY
Mailing Address - Zip Code:12865-4101
Mailing Address - Country:US
Mailing Address - Phone:518-956-1459
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 980489
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0489
Practice Address - Country:US
Practice Address - Phone:804-828-3266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-25
Last Update Date:2024-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent