Provider Demographics
NPI:1033509666
Name:KAVISH, NAOMI (LMHC)
Entity Type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:KAVISH
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 2ND AVE
Mailing Address - Street 2:STE#: 20G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-4010
Mailing Address - Country:US
Mailing Address - Phone:917-456-6921
Mailing Address - Fax:212-977-1057
Practice Address - Street 1:400 2ND AVE
Practice Address - Street 2:STE#: 20G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4010
Practice Address - Country:US
Practice Address - Phone:917-456-6921
Practice Address - Fax:212-977-1057
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005828-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health