Provider Demographics
NPI:1215090063
Name:GEORGIEVA-KAZAKOV, MILENA (LCSW)
Entity type:Individual
Prefix:MS
First Name:MILENA
Middle Name:
Last Name:GEORGIEVA-KAZAKOV
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 W 90TH ST
Mailing Address - Street 2:19E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-1504
Mailing Address - Country:US
Mailing Address - Phone:212-706-7559
Mailing Address - Fax:
Practice Address - Street 1:177 PRINCE ST
Practice Address - Street 2:APT 504
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-2935
Practice Address - Country:US
Practice Address - Phone:212-706-7559
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0725701041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical