Healthcare Provider Details

I. General information

NPI: 1356122519
Provider Name (Legal Business Name): KESHIA CARR LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 RADISSON PLZ FL 8
NEW ROCHELLE NY
10801-5766
US

IV. Provider business mailing address

900 CO OP CITY BLVD APT 18E
BRONX NY
10475-1611
US

V. Phone/Fax

Practice location:
  • Phone: 917-923-6053
  • Fax:
Mailing address:
  • Phone: 917-923-6053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number018189
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number2696521
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: