Provider Demographics
NPI:1659478626
Name:KAHN, AMY E (PSYD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:E
Last Name:KAHN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 MAIN STREET
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3128
Mailing Address - Country:US
Mailing Address - Phone:413-586-7172
Mailing Address - Fax:
Practice Address - Street 1:151 MAIN STREET
Practice Address - Street 2:SUITE 2
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3128
Practice Address - Country:US
Practice Address - Phone:413-586-7172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4962103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA407169OtherTUFTS
MA290896OtherMAGELLAN
MAW04719Medicare ID - Type Unspecified