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General NPI Number Information
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NPI Number | 1265674840
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Entity Type | Individual
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Provider Name | DOUGLAS KABAT LCSW
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Gender | Male
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Dates
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Enumeration Date | 03/30/2009
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Last Update Date | 03/30/2009
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Provider Practice Location Address
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Address Line | 864 BEECH DR
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City | NISKAYUNA
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State | NY
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Zip | 12309-3027
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Country | US
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Telephone | 518-275-9942
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Fax | 877-296-7673
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Provider Business Mailing Address
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Address Line | 864 BEECH DR
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City | NISKAYUNA
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State | NY
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Zip | 12309-3027
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Country | US
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Telephone | 518-275-9942
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Fax | 877-296-7673
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 2316
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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 | PR015438-1
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License Number State | NY
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