Provider Demographics
NPI:1558019711
Name:CANADY, PRESS LEWIS (LMSW)
Entity Type:Individual
Prefix:MR
First Name:PRESS
Middle Name:LEWIS
Last Name:CANADY
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 W 155TH ST APT 6D
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-7808
Mailing Address - Country:US
Mailing Address - Phone:212-491-9721
Mailing Address - Fax:
Practice Address - Street 1:509 W 155TH ST APT 6D
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-7808
Practice Address - Country:US
Practice Address - Phone:917-940-7193
Practice Address - Fax:718-546-2591
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101612-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker