Provider Demographics
NPI:1427464676
Name:KAHN, JESSE (LCSW-R, CST)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:KAHN
Suffix:
Gender:M
Credentials:LCSW-R, CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:850 7TH AVE STE 1106
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-0029
Mailing Address - Country:US
Mailing Address - Phone:646-797-4340
Mailing Address - Fax:646-205-8239
Practice Address - Street 1:850 7TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5230
Practice Address - Country:US
Practice Address - Phone:646-389-6561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-09
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0237751041C0700X
NY085142-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical