Provider Demographics
NPI:1184438194
Name:KADAN, CHARLIE DEAN (LCSW)
Entity type:Individual
Prefix:
First Name:CHARLIE
Middle Name:DEAN
Last Name:KADAN
Suffix:
Gender:X
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2222 36TH ST APT 2
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11105-2211
Mailing Address - Country:US
Mailing Address - Phone:347-450-8326
Mailing Address - Fax:
Practice Address - Street 1:2222 36TH ST APT 2
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11105-2211
Practice Address - Country:US
Practice Address - Phone:347-450-8326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0945601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical