Provider Demographics
NPI:1215152277
Name:RANFTLE, KEVIN B (LCSW)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:B
Last Name:RANFTLE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 PARK AVE
Mailing Address - Street 2:APT. 2-F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3838
Mailing Address - Country:US
Mailing Address - Phone:917-690-5070
Mailing Address - Fax:
Practice Address - Street 1:35 PARK AVE
Practice Address - Street 2:APT. 2-F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3838
Practice Address - Country:US
Practice Address - Phone:917-690-5070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR049304-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical