Provider Demographics
NPI:1336652486
Name:SEEGER, KITAMA S (LMSW)
Entity Type:Individual
Prefix:MR
First Name:KITAMA
Middle Name:S
Last Name:SEEGER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 W 155TH ST APT 4C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-7807
Mailing Address - Country:US
Mailing Address - Phone:646-510-5710
Mailing Address - Fax:
Practice Address - Street 1:341 E 79TH ST APT 306
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-1039
Practice Address - Country:US
Practice Address - Phone:718-928-4873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-12
Last Update Date:2017-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY098674104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker