Provider Demographics
NPI:1164698007
Name:KANE, NADJA (LMSW)
Entity Type:Individual
Prefix:
First Name:NADJA
Middle Name:
Last Name:KANE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:179 EAGLE ST
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12202-1744
Mailing Address - Country:US
Mailing Address - Phone:718-501-7056
Mailing Address - Fax:
Practice Address - Street 1:179 EAGLE ST
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12202-1744
Practice Address - Country:US
Practice Address - Phone:718-501-7056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY076197104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker