Provider Demographics
NPI:1518053990
Name:VOUYIOUKLIS, KIKI (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KIKI
Middle Name:
Last Name:VOUYIOUKLIS
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 1:196 BAY 47TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11214-6812
Mailing Address - Country:US
Mailing Address - Phone:718-946-0893
Mailing Address - Fax:
Practice Address - Street 1:333 AVENUE X
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-5947
Practice Address - Country:US
Practice Address - Phone:718-339-5300
Practice Address - Fax:718-339-9082
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR048944-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYKV0N1M3410Medicare ID - Type Unspecified