Provider Demographics
NPI:1114220985
Name:KOHN, JUDITH DIANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JUDITH
Middle Name:DIANNE
Last Name:KOHN
Suffix:
Gender:F
Credentials:LCSW
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Other - Credentials:
Mailing Address - Street 1:105 CLOVER DR
Mailing Address - Street 2:PUPILK PERSONNEL SERVICES-GREAT NECK PUBLIC SCHOOLS
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-1031
Mailing Address - Country:US
Mailing Address - Phone:516-441-4970
Mailing Address - Fax:516-441-4270
Practice Address - Street 1:105 CLOVER DR
Practice Address - Street 2:PUPILK PERSONNEL SERVICES-GREAT NECK PUBLIC SCHOOLS
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-1031
Practice Address - Country:US
Practice Address - Phone:516-441-4970
Practice Address - Fax:516-441-4270
Is Sole Proprietor?:No
Enumeration Date:2010-12-16
Last Update Date:2010-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0371021041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool