Provider Demographics
NPI:1235253949
Name:KAHN, CECILY (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CECILY
Middle Name:
Last Name:KAHN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 W SLAUSON AVE
Mailing Address - Street 2:SUITE 287
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6590
Mailing Address - Country:US
Mailing Address - Phone:310-338-9108
Mailing Address - Fax:310-338-9108
Practice Address - Street 1:5601 W SLAUSON AVE
Practice Address - Street 2:SUITE 287
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6590
Practice Address - Country:US
Practice Address - Phone:310-338-9108
Practice Address - Fax:310-338-9108
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 7873103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SW78738Medicare ID - Type Unspecified