Healthcare Provider Details

I. General information

NPI: 1093846222
Provider Name (Legal Business Name): STEVEN R KANE PH.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 06/21/2026
Certification Date: 06/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4905 CUSHING DR
KENSINGTON MD
20895-1217
US

IV. Provider business mailing address

4905 CUSHING DR
KENSINGTON MD
20895-1217
US

V. Phone/Fax

Practice location:
  • Phone: 240-476-8764
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810007669
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY10001964
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY1000141
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number04040
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: