Provider Demographics
NPI:1831456763
Name:KASS, AMY S (LCSWR)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:S
Last Name:KASS
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:507 FIFTH AVE
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:NY
Mailing Address - Zip Code:10803-1205
Mailing Address - Country:US
Mailing Address - Phone:914-738-1728
Mailing Address - Fax:914-738-7221
Practice Address - Street 1:507 FIFTH AVE
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:NY
Practice Address - Zip Code:10803-1205
Practice Address - Country:US
Practice Address - Phone:914-738-1728
Practice Address - Fax:914-738-7221
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-17
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR050528-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical