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NPI 1669021648

NPI 1669021648 : KATHRYN GROOMS, LCSW PC : NEW YORK, NY

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General NPI Number Information
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    NPI Number           |    1669021648
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    Entity Type          |    Organization 
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    Legal Business Name  |    KATHRYN GROOMS, LCSW PC 
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Dates
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    Enumeration Date     |    09/11/2019
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    Last Update Date     |    09/11/2019
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Provider Practice Location Address
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    Address Line         |    49 W 24TH ST STE 1004 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10010-3543
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    Country              |    US
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    Telephone            |    347-752-1157
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    49 W 24TH ST STE 1004 
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    City                 |    NEW YORK
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    State                |    NY
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    Zip                  |    10010-3543
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    Country              |    US
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    Telephone            |    347-752-1157
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    Fax                  |    
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Authorized Official
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    Title or Position    |    FOUNDER
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    Name                 |     KATHRYN  GROOMS 
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    Credential           |    LCSW
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    Telephone            |    347-752-1157
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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       |    
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    License Number State |    
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