Healthcare Provider Details

I. General information

NPI: 1962577551
Provider Name (Legal Business Name): KATHRYN FLYNN M.S.W.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 EAST 21ST STREET THE FIFTH AVENUE CENTER
NEW YORK NY
10010
US

IV. Provider business mailing address

170 E 79TH ST APT.14B
NEW YORK NY
10021-0436
US

V. Phone/Fax

Practice location:
  • Phone: 646-205-8224
  • Fax:
Mailing address:
  • Phone: 646-942-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: