MR. JOHN MCKEITHEN M.ED LPC LADC. NPI 1770772576

NPI Information

NPI: 1770772576
Provider Name: MR. JOHN MCKEITHEN, M.ED, LPC, LADC.
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

PECOS Registration: Yes

Address:
495 CONGRESS AVE
NEW HAVEN, CT
ZIP 06519
Phone: (203) 781-4600
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MR. John Mckeithen, M.ED, LPC, LADC. is an addiction (substance use disorder) counselor in New Haven, CT. MR. John Mckeithen, M.ED, LPC, LADC. NPI is 1770772576. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

495 CONGRESS AVE
NEW HAVEN, CT
ZIP 06519-312
Phone: (203) 781-4600
Fax: (203) 781-4624

The NPI 1770772576 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 10/17/2007 and was last updated on 1/24/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YP2500X	Counselor	Professional	001918	CONNECTICUT	No
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	00631	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	008001325	MEDICAID	CONNECTICUT
2	008022622	MEDICAID	CONNECTICUT
3	004082260	MEDICAID	CONNECTICUT
4	0080494436	MEDICAID	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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