Provider Demographics
NPI:1982734901
Name:TALBOT, KATHLEEN E (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:E
Last Name:TALBOT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 DECATUR AVE
Mailing Address - Street 2:
Mailing Address - City:PEEKSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:10566-2110
Mailing Address - Country:US
Mailing Address - Phone:914-737-9099
Mailing Address - Fax:
Practice Address - Street 1:410 DECATUR AVE
Practice Address - Street 2:
Practice Address - City:PEEKSKILL
Practice Address - State:NY
Practice Address - Zip Code:10566-2110
Practice Address - Country:US
Practice Address - Phone:914-737-9099
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY07321411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical