Provider Demographics
NPI:1679156897
Name:KASHMANN-MYROW, URIAH S (LICSW)
Entity Type:Individual
Prefix:
First Name:URIAH
Middle Name:S
Last Name:KASHMANN-MYROW
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 WOODFORD ST # 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02125-2724
Mailing Address - Country:US
Mailing Address - Phone:845-544-3740
Mailing Address - Fax:
Practice Address - Street 1:36 DEARBORN ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02119-2552
Practice Address - Country:US
Practice Address - Phone:857-352-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-05
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1228191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical