MEDICARE: KARA KOHN-GARDNER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1679411284
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KARA KOHN-GARDNER LLC

Provider Business Mailing Address
First Line	:	301 W 105TH ST APT 4F
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10025-3406
Country	:	US
Telephone Number	:	917-574-6413
Fax Number	:

Provider Business Practice Location Address
First Line	:	631 W END AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-1034
Country	:	US
Telephone Number	:	917-574-6413
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	KARA KOHN-GARDNER
Credential	:
Telephone Number	:	917-574-6413

Provider Enumeration Date	:	03/24/2026
Last Update Date	:	03/24/2026

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