Provider Demographics
NPI:1154987501
Name:KAHN, MIRIAM ROSE (LGSW)
Entity type:Individual
Prefix:
First Name:MIRIAM
Middle Name:ROSE
Last Name:KAHN
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3069 RIVERVIEW RD
Mailing Address - Street 2:
Mailing Address - City:RIVA
Mailing Address - State:MD
Mailing Address - Zip Code:21140-1332
Mailing Address - Country:US
Mailing Address - Phone:240-498-9884
Mailing Address - Fax:
Practice Address - Street 1:3413 OLANDWOOD CT STE 203
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-1489
Practice Address - Country:US
Practice Address - Phone:301-683-5680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-11
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD22616104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker