Provider Demographics
NPI:1306982525
Name:CONTINI, KATHRYN (LCSW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:CONTINI
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 1:126 PARK AVE
Mailing Address - Street 2:1B
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13903-3280
Mailing Address - Country:US
Mailing Address - Phone:607-772-1883
Mailing Address - Fax:
Practice Address - Street 1:126 PARK AVE
Practice Address - Street 2:1B
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13903-3280
Practice Address - Country:US
Practice Address - Phone:607-772-1883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR027823-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01715695Medicaid
NY01715695Medicaid