Provider Demographics
NPI:1124319538
Name:ADMIRAND, KATHLEEN (MSW)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:ADMIRAND
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6725 188TH ST
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3767
Mailing Address - Country:US
Mailing Address - Phone:718-454-6460
Mailing Address - Fax:
Practice Address - Street 1:14 LINWOOD RD N
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1412
Practice Address - Country:US
Practice Address - Phone:646-831-3763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055831104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker