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General NPI Number Information
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NPI Number | 1184108029
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Entity Type | Individual
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Provider Name | LISA KANNER LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/17/2018
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Last Update Date | 09/17/2018
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Provider Practice Location Address
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Address Line | 201 EAST 28TH STREER APT 8B
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City | NEW YORK
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State | NY
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Zip | 10016-8358
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Country | US
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Telephone | 646-315-0857
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Fax |
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Provider Business Mailing Address
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Address Line | 201 E 28TH ST APT 8B
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City | NEW YORK
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State | NY
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Zip | 10016-8538
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Country | US
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Telephone |
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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 | 73071658
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 7307165
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License Number State | NY
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