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General NPI Number Information
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NPI Number | 1972606044
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Entity Type | Individual
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Provider Name | BONNIE C. KAUDER LCSW, CASAC
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Gender | Female
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 19 W 34TH ST SUITE PH
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City | NEW YORK
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State | NY
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Zip | 10001-3006
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Country | US
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Telephone | 917-848-8236
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Fax |
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Provider Business Mailing Address
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Address Line | 269-10 GRAND CENTRAL PARKWAY APT. 3U
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City | FLORAL PARK
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State | NY
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Zip | 11005-1003
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Country | US
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Telephone | 718-225-0821
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 5078
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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 | R0368751
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License Number State | NY
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