Provider Demographics
NPI:1699345892
Name:KIRTON, KASHAWN JAMAL
Entity type:Individual
Prefix:
First Name:KASHAWN
Middle Name:JAMAL
Last Name:KIRTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 ROCKAWAY PKWY APT 3R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11212-3640
Mailing Address - Country:US
Mailing Address - Phone:917-586-7248
Mailing Address - Fax:
Practice Address - Street 1:155 ROCKAWAY PKWY APT 3R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11212-3640
Practice Address - Country:US
Practice Address - Phone:917-586-7248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-29
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical