Provider Demographics
NPI:1942379995
Name:KANE, ROBERT ALAN (MS LP LMFT LICSW)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:ALAN
Last Name:KANE
Suffix:
Gender:M
Credentials:MS LP LMFT LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 RAMSEY STREET
Mailing Address - Street 2:
Mailing Address - City:ST PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-2323
Mailing Address - Country:US
Mailing Address - Phone:651-227-5508
Mailing Address - Fax:
Practice Address - Street 1:311 RAMSEY STREET
Practice Address - Street 2:
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2323
Practice Address - Country:US
Practice Address - Phone:651-227-5508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2526103T00000X
MN118331041C0700X
MN80106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist