Provider Demographics
NPI:1588005995
Name:KAHN, DEBORAH C (LICSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:C
Last Name:KAHN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 LINCOLN RD
Mailing Address - Street 2:P.O. BOX 366
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-3832
Mailing Address - Country:US
Mailing Address - Phone:617-930-2855
Mailing Address - Fax:
Practice Address - Street 1:152 LINCOLN RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-3832
Practice Address - Country:US
Practice Address - Phone:617-930-2855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-13
Last Update Date:2013-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1144971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical