Provider Demographics
NPI:1972775773
Name:KANO PSYCHOTHERAPY LIMITED
Entity type:Organization
Organization Name:KANO PSYCHOTHERAPY LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:NEFF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:414-291-9184
Mailing Address - Street 1:1301 N ASTOR ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-2887
Mailing Address - Country:US
Mailing Address - Phone:414-291-9184
Mailing Address - Fax:
Practice Address - Street 1:1301 N ASTOR ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53202-2887
Practice Address - Country:US
Practice Address - Phone:414-291-9184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI684-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty