=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750489142
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MALKAH LESMAN-KAPLAN LCSW-R,ACSW,DAPA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/20/2006
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23 S BROADWAY
-----------------------------------------------------
City | WHITE PLAINS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10601-3503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-421-1951
-----------------------------------------------------
Fax | 914-421-1956
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 410 KIMBALL AVE
-----------------------------------------------------
City | YONKERS
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10704-2327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 718-427-4564
-----------------------------------------------------
Fax | 914-421-1956
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | R028484-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------