Provider Demographics
NPI:1265814115
Name:DUFFY, KEVEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KEVEN
Middle Name:
Last Name:DUFFY
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 1:299 BROADWAY STE 820
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1974
Mailing Address - Country:US
Mailing Address - Phone:917-548-4240
Mailing Address - Fax:
Practice Address - Street 1:299 BROADWAY STE 820
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1974
Practice Address - Country:US
Practice Address - Phone:917-548-4240
Practice Address - Fax:212-564-1740
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-26
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0865201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical