Provider Demographics
NPI:1912699414
Name:DEVANEY, KATE (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:KATE
Middle Name:
Last Name:DEVANEY
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:
Other - Last Name:SHAW
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:15 GRUMMAN RD. WEST
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5028
Mailing Address - Country:US
Mailing Address - Phone:516-465-4700
Mailing Address - Fax:516-465-4740
Practice Address - Street 1:15 GRUMMAN RD. WEST
Practice Address - Street 2:SUITE 1000
Practice Address - City:BETHPAGE
Practice Address - State:NY
Practice Address - Zip Code:11714-5028
Practice Address - Country:US
Practice Address - Phone:516-465-4700
Practice Address - Fax:516-465-4740
Is Sole Proprietor?:No
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0766111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical