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NPI Code Detail

MEDICARE: KATHLEEN MARIE MCINTYRE LCSW

MEDICARE: KATHLEEN MARIE MCINTYRE LCSW
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
11041C0700XClinical Social Worker084095NY
2104100000XSocial Worker085127NY

General Provider Information

NPI Number : 1942570007
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN MARIE MCINTYRE LCSW
Provider Business Mailing Address
First Line : 630 W 168TH ST STE 1540
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3725
Country : US
Telephone Number : 646-774-8935
Fax Number :
Provider Business Practice Location Address
First Line : 622 W 168TH ST STE 1540
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3720
Country : US
Telephone Number : 717-725-2176
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2012
Last Update Date : 10/31/2019

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Directions to “ KATHLEEN MARIE MCINTYRE LCSW” Practice Location

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