Healthcare Provider Details

I. General information

NPI: 1851569222
Provider Name (Legal Business Name): STEPHEN E. KOHN LCSW P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2008
Last Update Date: 03/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 W RED OAK LN 4TH FLOOR
WHITE PLAINS NY
10604-3611
US

IV. Provider business mailing address

70 WEST RED OAK LANE 4TH FLOOR
WHITE PLAINS NY
10604-3611
US

V. Phone/Fax

Practice location:
  • Phone: 914-686-2552
  • Fax:
Mailing address:
  • Phone: 914-686-2552
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberR031094
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251T00000X
TaxonomyPACE Provider Organization
License NumberR031094
License Number StateNY

VIII. Authorized Official

Name: MR. STEPHEN ERIC KOHN
Title or Position: PRESIDENT
Credential: CSW
Phone: 914-686-2552