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General NPI Number Information
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NPI Number | 1356560452
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Entity Type | Organization
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Legal Business Name | KEVIN PHILLIPS PHD
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Dates
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Enumeration Date | 04/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 16 DAKIN AVENUE
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City | MOUNT KISCO
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State | NY
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Zip | 10549
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Country | US
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Telephone | 914-674-9272
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Fax |
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Provider Business Mailing Address
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Address Line | 984 NORTH BROADWAY SUITE 411
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City | YONKERS
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State | NY
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Zip | 10701-1308
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Country | US
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Telephone | 914-674-9272
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN PHILLIPS
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Credential | LCSW PHD
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Telephone | 914-674-9272
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | R0288161
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License Number State | NY
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