Provider Demographics
NPI:1932732039
Name:KESSLER, ROBYN KETOVER (LPC)
Entity type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:KETOVER
Last Name:KESSLER
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 1:40 AVONRIDGE
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-4039
Mailing Address - Country:US
Mailing Address - Phone:203-962-5375
Mailing Address - Fax:
Practice Address - Street 1:300 HEBRON AVE STE 217
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2195
Practice Address - Country:US
Practice Address - Phone:860-659-2697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT003948101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty