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General NPI Number Information
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NPI Number | 1952147449
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Entity Type | Organization
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Legal Business Name | DR NAHAL C KAIVAN PSYCHOLOGICAL SERVICES PLLC
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Dates
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Enumeration Date | 07/03/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 2001 PALMER AVE STE 205
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City | LARCHMONT
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State | NY
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Zip | 10538-2420
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Country | US
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Telephone | 917-979-8736
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Fax | 914-292-9166
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Provider Business Mailing Address
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Address Line | 2001 PALMER AVE STE 205
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City | LARCHMONT
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State | NY
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Zip | 10538-2420
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Country | US
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Telephone | 917-979-8736
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Fax | 914-292-9166
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Authorized Official
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Title or Position | OWNER/CLINIC DIRECTOR
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Name | NAHAL KAIVAN
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Credential | PH.D.
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Telephone | 858-735-5425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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