Provider Demographics
NPI:1558034868
Name:KABORE, DESIREE (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:DESIREE
Middle Name:
Last Name:KABORE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:437 IRVING AVE APT 6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-6016
Mailing Address - Country:US
Mailing Address - Phone:347-962-6510
Mailing Address - Fax:
Practice Address - Street 1:437 IRVING AVE APT 6
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-6016
Practice Address - Country:US
Practice Address - Phone:347-962-6510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-01
Last Update Date:2021-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW137731104100000X
NY113201104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker