Provider Demographics
NPI:1871238626
Name:KILKENNY, DAWN L
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:L
Last Name:KILKENNY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 LEXINGTON AVENUE,
Mailing Address - Street 2:SUITE 2, #1250
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028
Mailing Address - Country:US
Mailing Address - Phone:680-766-9303
Mailing Address - Fax:
Practice Address - Street 1:1280 LEXINGTON AVENUE
Practice Address - Street 2:SUITE 2, 1250
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10028
Practice Address - Country:US
Practice Address - Phone:680-766-9303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0722731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical