Provider Demographics
NPI:1669997110
Name:DE LAS HERAS KUHN, LOURDES (MRES, LMSW)
Entity type:Individual
Prefix:
First Name:LOURDES
Middle Name:
Last Name:DE LAS HERAS KUHN
Suffix:
Gender:F
Credentials:MRES, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 100TH ST APT 521
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025-5325
Mailing Address - Country:US
Mailing Address - Phone:203-589-6699
Mailing Address - Fax:
Practice Address - Street 1:1 GUSTAVE L LEVY PL # 1252
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6504
Practice Address - Country:US
Practice Address - Phone:212-523-5937
Practice Address - Fax:212-523-2253
Is Sole Proprietor?:No
Enumeration Date:2017-08-06
Last Update Date:2017-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100618-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker