Provider Demographics
NPI:1841604584
Name:KAHN, KIMBERLY A (LCSW)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:A
Last Name:KAHN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KIMBERLY
Other - Middle Name:A
Other - Last Name:SHANSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:17 CHARLES CT
Mailing Address - Street 2:
Mailing Address - City:OCEAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-7939
Mailing Address - Country:US
Mailing Address - Phone:917-659-2101
Mailing Address - Fax:
Practice Address - Street 1:1205 STATE ROUTE 35
Practice Address - Street 2:
Practice Address - City:OCEAN
Practice Address - State:NJ
Practice Address - Zip Code:07712-4077
Practice Address - Country:US
Practice Address - Phone:971-659-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-19
Last Update Date:2018-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0819381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical