Provider Demographics
NPI:1073848289
Name:NAAB, KATHLEEN MARIE (MSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MARIE
Last Name:NAAB
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:NAAB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:KATHLEEN NAAB
Mailing Address - Street 1:3150 ROCHAMBEAU AVE
Mailing Address - Street 2:D 23
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-3803
Mailing Address - Country:US
Mailing Address - Phone:610-506-6822
Mailing Address - Fax:
Practice Address - Street 1:260 E 188TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10458-5302
Practice Address - Country:US
Practice Address - Phone:718-960-0260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-05
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0795191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical