Provider Demographics
NPI:1821671264
Name:HAHN, KRISTEN V (LCSW)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:V
Last Name:HAHN
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 1:689 MYRTLE AVE APT 2I
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11205-3988
Mailing Address - Country:US
Mailing Address - Phone:607-321-1441
Mailing Address - Fax:
Practice Address - Street 1:1125 FULTON ST STE 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-2669
Practice Address - Country:US
Practice Address - Phone:347-226-9025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-04
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103770104100000X
NY0923761041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker