Provider Demographics
NPI:1821258948
Name:KOHN-TRATTNER, AMIRA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:AMIRA
Middle Name:
Last Name:KOHN-TRATTNER
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 1:25 CENTRAL PARK WEST
Mailing Address - Street 2:SUITE #1-E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023
Mailing Address - Country:US
Mailing Address - Phone:212-496-8486
Mailing Address - Fax:212-874-8290
Practice Address - Street 1:25 CENTRAL PARK WEST
Practice Address - Street 2:SUITE #1-E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023
Practice Address - Country:US
Practice Address - Phone:212-496-8486
Practice Address - Fax:212-874-8290
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR025099102L00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
R025099OtherSTATE LIC