Provider Demographics
NPI:1831469097
Name:KLAVAN, JOAN SIMPSON (LCSW)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:SIMPSON
Last Name:KLAVAN
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 1:1000 10TH AVE
Mailing Address - Street 2:#8G-61
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-1147
Mailing Address - Country:US
Mailing Address - Phone:212-523-6860
Mailing Address - Fax:212-523-6494
Practice Address - Street 1:1000 10TH AVE
Practice Address - Street 2:#8G-61
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-1147
Practice Address - Country:US
Practice Address - Phone:212-523-6860
Practice Address - Fax:212-523-6494
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR033771-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical