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General NPI Number Information
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NPI Number | 1881794907
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Entity Type | Individual
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Provider Name | KATHLEEN BRONNER FIKS LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10848 70TH RD
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City | FOREST HILLS
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State | NY
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Zip | 11375-3961
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Country | US
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Telephone | 718-261-3696
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Fax | 201-568-4494
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Provider Business Mailing Address
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Address Line | 83 GLENWOOD RD
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City | TENAFLY
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State | NJ
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Zip | 07670-1135
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Country | US
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Telephone | 201-569-1819
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Fax | 201-568-4494
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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 | R006078
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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 | 44SC00090300
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License Number State | NJ
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