Provider Demographics
NPI:1346569753
Name:KINEHELOE, WILLIAM FREDERICK JR (R-LCSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:FREDERICK
Last Name:KINEHELOE
Suffix:JR
Gender:M
Credentials:R-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WEST 65TH STREET FLOOR #2
Mailing Address - Street 2:ESTHER ASHKENAS CENTRAL PARK EARLY LEARNING CENTER
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-787-5400
Mailing Address - Fax:212-787-0084
Practice Address - Street 1:15 WEST 65TH STREET FLOOR #2
Practice Address - Street 2:ESTHER ASHKENAS CENTRAL PARK EARLY LEARNING CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-787-5400
Practice Address - Fax:212-787-0084
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0444301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical