Provider Demographics
NPI:1336703925
Name:VOORHEES, KEN (LCSW)
Entity Type:Individual
Prefix:
First Name:KEN
Middle Name:
Last Name:VOORHEES
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 W 18TH ST APT 3FE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-4510
Mailing Address - Country:US
Mailing Address - Phone:347-831-1799
Mailing Address - Fax:
Practice Address - Street 1:235 W 18TH ST APT 3FE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-4510
Practice Address - Country:US
Practice Address - Phone:347-831-1799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-29
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR063920-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical