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General NPI Number Information
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NPI Number | 1104445956
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Entity Type | Individual
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Provider Name | ADRIANA MAYA KAYE DSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/13/2020
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Last Update Date | 01/31/2024
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Provider Practice Location Address
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Address Line | 112 GUN CLUB ROAD
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City | MILLERTON
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State | NY
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Zip | 12546-0505
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Country | US
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Telephone | 518-560-0322
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 505
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City | MILLERTON
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State | NY
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Zip | 12546-0505
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Country | US
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Telephone | 518-560-0322
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 096910
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License Number State | NY
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