Provider Demographics
NPI:1962816280
Name:KAHN, DANA (LICSW)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:KAHN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4860 RAINIER AVE S STE C
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-6305
Mailing Address - Country:US
Mailing Address - Phone:206-316-1812
Mailing Address - Fax:
Practice Address - Street 1:4860 RAINIER AVE S STE C
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-6305
Practice Address - Country:US
Practice Address - Phone:206-316-1812
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-14
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW 60395446101YM0800X
WALW603954461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health