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NPI Code Detail

MEDICARE: MS. KATHLEEN MARIE DOYLE LMSW

MEDICARE: MS. KATHLEEN MARIE DOYLE LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker073103MNY

General Provider Information

NPI Number : 1508031261
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. KATHLEEN MARIE DOYLE LMSW
Provider Business Mailing Address
First Line : 810 CLASSON AVENUE
Second Line : COMMUNITY COUNSELING & MEDIATION
City : BROOKLYN
State : NY
Zip : 11238-6102
Country : US
Telephone Number : 917-701-6253
Fax Number :
Provider Business Practice Location Address
First Line : 810 CLASSON AVENUE
Second Line : COMMUNITY COUNSELING & MEDIATION
City : BROOKLYN
State : NY
Zip : 11238-6102
Country : US
Telephone Number : 917-701-6253
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/24/2008
Last Update Date : 04/24/2008

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