Provider Demographics
NPI:1750870994
Name:KACH, ERNEST DAVID (LMSW)
Entity type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:DAVID
Last Name:KACH
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 1:17 CHITTENDEN AVE APT 5B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10033-1131
Mailing Address - Country:US
Mailing Address - Phone:676-670-8172
Mailing Address - Fax:212-781-5530
Practice Address - Street 1:17 CHITTENDEN AVE APT 5B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10033-1131
Practice Address - Country:US
Practice Address - Phone:676-670-8172
Practice Address - Fax:212-781-5530
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY075702104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY075702OtherNYSED