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General NPI Number Information
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NPI Number | 1073399234
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Entity Type | Individual
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Provider Name | KELSEY LACATIVA PSY.D.
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Gender | Female
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Dates
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Enumeration Date | 09/05/2023
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Last Update Date | 10/08/2023
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Provider Practice Location Address
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Address Line | 1 CHASE RD STE 203
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City | SCARSDALE
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State | NY
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Zip | 10583-4160
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Country | US
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Telephone | 914-572-4959
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Fax |
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Provider Business Mailing Address
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Address Line | 1 CHASE RD STE 203
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City | SCARSDALE
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State | NY
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Zip | 10583-4160
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Country | US
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Telephone | 917-620-8749
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | P123982
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License Number State | NY
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