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Provider Information for 1376616425


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Ms. KATHARINE LOUISE KIESEL LCSW


Sex: Female

NPI: 1376616425
Last Updated: 2007-07-08
Certification Date:

Details

NameValue
NPI1376616425
Enumeration Date2006-11-16
NPI TypeNPI-1 Individual
Sole ProprietorNO
StatusActive
Mailing Address 2235 35TH ST
ASTORIA, NY 11105-2206
United States

Phone: 718-267-7540 | Fax:
 
Primary Practice Address 1727 AMSTERDAM AVE
NEW YORK, NY 10031-4611
United States

Phone: 212-694-9200 | Fax:212-368-5608
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 1041C0700X - Social Worker - ClinicalNY070848-1