Healthcare Provider Details

I. General information

NPI: 1326452491
Provider Name (Legal Business Name): SOPHIE KAY M.A., ED.M
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2014
Last Update Date: 08/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 W BROAD ST
STAMFORD CT
06902-3713
US

IV. Provider business mailing address

2367-69 SECOND AVE HARLEM EAST LIFE PLAN
NEW YORK NY
10035
US

V. Phone/Fax

Practice location:
  • Phone: 203-324-6127
  • Fax: 203-348-9378
Mailing address:
  • Phone: 212-876-2300
  • Fax: 917-492-9202

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: