Provider Demographics
NPI:1649750084
Name:AMIN, KAREN ANN SUSANNA (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN ANN
Middle Name:SUSANNA
Last Name:AMIN
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 1:315 5TH AVE RM 601
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6591
Mailing Address - Country:US
Mailing Address - Phone:646-733-6529
Mailing Address - Fax:646-774-0385
Practice Address - Street 1:315 5TH AVE RM 601
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6591
Practice Address - Country:US
Practice Address - Phone:646-733-6529
Practice Address - Fax:646-774-0385
Is Sole Proprietor?:No
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079228-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical