Provider Demographics
NPI:1396020988
Name:KANTROWITZ, PETER ADAM (LCSW-R, CSSW)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:ADAM
Last Name:KANTROWITZ
Suffix:
Gender:M
Credentials:LCSW-R, CSSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-3123
Mailing Address - Country:US
Mailing Address - Phone:518-439-2831
Mailing Address - Fax:
Practice Address - Street 1:700 WASHINTON AVENUE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12203
Practice Address - Country:US
Practice Address - Phone:518-454-3987
Practice Address - Fax:518-437-0476
Is Sole Proprietor?:No
Enumeration Date:2011-10-15
Last Update Date:2011-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730652541041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool