Healthcare Provider Details

I. General information

NPI: 1629704374
Provider Name (Legal Business Name): JAMIE-LYNN KANE LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2022
Last Update Date: 02/25/2025
Certification Date: 02/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 NEW SCOTLAND AVE
ALBANY NY
12208-3409
US

IV. Provider business mailing address

75 NEW SCOTLAND AVE
ALBANY NY
12208-3409
US

V. Phone/Fax

Practice location:
  • Phone: 518-549-6002
  • Fax:
Mailing address:
  • Phone: 518-549-6002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberMC21277
License Number StateME
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number126109-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: