Provider Demographics
NPI:1093173650
Name:KANE, STEPHEN (LMHC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:KANE
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6228 VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-3741
Mailing Address - Country:US
Mailing Address - Phone:727-846-7233
Mailing Address - Fax:727-846-7200
Practice Address - Street 1:10347 CROSS CREEK BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-2993
Practice Address - Country:US
Practice Address - Phone:727-514-4113
Practice Address - Fax:727-846-7200
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13790101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health