Provider Demographics
NPI:1306383948
Name:HUMMEL, KERRIGAN PAIGE (LCSW)
Entity Type:Individual
Prefix:
First Name:KERRIGAN
Middle Name:PAIGE
Last Name:HUMMEL
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 1:330 W 15TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11011
Mailing Address - Country:US
Mailing Address - Phone:516-512-0713
Mailing Address - Fax:
Practice Address - Street 1:1090 SAINT NICHOLAS AVE FRNT A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3809
Practice Address - Country:US
Practice Address - Phone:212-543-3369
Practice Address - Fax:844-906-2434
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0991341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical