Healthcare Provider Details

I. General information

NPI: 1952715450
Provider Name (Legal Business Name): KATE OKAMOTO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2014
Last Update Date: 06/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 COOPER ST APT 4J
NEW YORK NY
10034-3076
US

IV. Provider business mailing address

60 COOPER ST APT 4J
NEW YORK NY
10034-3076
US

V. Phone/Fax

Practice location:
  • Phone: 917-573-9190
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number081461-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: