MEDICARE: NATALIE KAGAN LCSWR

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	R067415	NY

General Provider Information

NPI Number	:	1952499121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATALIE KAGAN LCSWR

Provider Business Mailing Address
First Line	:	7241 SHORE RD
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-1814
Country	:	US
Telephone Number	:	718-259-8655
Fax Number	:

Provider Business Practice Location Address
First Line	:	7 CORBIN PL UNIT C1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11235-4801
Country	:	US
Telephone Number	:	718-331-3800
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/11/2006
Last Update Date	:	07/08/2021

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