Provider Demographics
NPI:1992824825
Name:KAHANER, AMY R (LMHC)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:R
Last Name:KAHANER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 WENSLEY DRIVE
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11020
Mailing Address - Country:US
Mailing Address - Phone:516-482-7055
Mailing Address - Fax:
Practice Address - Street 1:15 BARSTOW RD
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-2229
Practice Address - Country:US
Practice Address - Phone:516-829-6978
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2010-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002805101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health