Healthcare Provider Details

I. General information

NPI: 1750106910
Provider Name (Legal Business Name): RACHEL CATHERINE AMEER MCKEON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/21/2024
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 TECHNOLOGY DR UNIT A301
TRUMBULL CT
06611-6347
US

IV. Provider business mailing address

11 PEARL ST APT 2
NEW HAVEN CT
06511-8822
US

V. Phone/Fax

Practice location:
  • Phone: 203-612-4300
  • Fax:
Mailing address:
  • Phone: 203-767-4123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number27.003522
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: