Provider Demographics
NPI:1962656371
Name:SAFAVI, KATAION (LMSW)
Entity Type:Individual
Prefix:MS
First Name:KATAION
Middle Name:
Last Name:SAFAVI
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 RIVERSIDE DR
Mailing Address - Street 2:9D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5209
Mailing Address - Country:US
Mailing Address - Phone:917-517-2156
Mailing Address - Fax:
Practice Address - Street 1:344 W 36TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-7598
Practice Address - Country:US
Practice Address - Phone:212-560-6784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-12
Last Update Date:2008-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077874-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health