Provider Demographics
NPI:1891464590
Name:UDY-CAUVIN, KRIS (LMSW)
Entity type:Individual
Prefix:MS
First Name:KRIS
Middle Name:
Last Name:UDY-CAUVIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:
Other - Last Name:CAUVIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:320 SARLES LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANTVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10570-1946
Mailing Address - Country:US
Mailing Address - Phone:914-208-1245
Mailing Address - Fax:
Practice Address - Street 1:320 SARLES LN
Practice Address - Street 2:
Practice Address - City:PLEASANTVILLE
Practice Address - State:NY
Practice Address - Zip Code:10570-1946
Practice Address - Country:US
Practice Address - Phone:914-208-1245
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077053104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker