Provider Demographics
NPI:1205140233
Name:KAHN, STEPHEN (MA / EDM / LMHC)
Entity type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:KAHN
Suffix:
Gender:M
Credentials:MA / EDM / LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 ACADEMY ST
Mailing Address - Street 2:SUITE 10G
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-4504
Mailing Address - Country:US
Mailing Address - Phone:917-494-2783
Mailing Address - Fax:
Practice Address - Street 1:160 ACADEMY ST
Practice Address - Street 2:SUITE 10G
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-4504
Practice Address - Country:US
Practice Address - Phone:917-494-2783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2017-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005025101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005025OtherNEW YORK STATE OFFICE OF PROFESSIONS LICENSE NUMBER LMHC