Provider Demographics
NPI:1316168222
Name:SAUNDERS, KEVIN MYLES (LCAT)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:MYLES
Last Name:SAUNDERS
Suffix:
Gender:M
Credentials:LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:647 EAST 11TH STREET, #6
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-1000
Mailing Address - Country:US
Mailing Address - Phone:212-260-0822
Mailing Address - Fax:
Practice Address - Street 1:41-51 EAST 11TH ST., 4TH FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-260-0822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05000758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health