Individual provider Active NPI

Paul Wyant Kahn, LCSW

  • Clinical Social Worker
  • Olivebridge, NY
National Provider Identifier
1194022293
Registry record updated Oct 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R079976 Issued in NY
Practice address
35 Haver Rd
Olivebridge, NY 12461-5007
Phone
(201) 616-9263
Fax
(912) 219-0790
NPI assigned
Feb 25, 2011
Last updated
Oct 4, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 4, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CSW007658 GA
Clinical Social Worker 1041C0700X R079976 NY Primary
Clinical Social Worker 1041C0700X LICSW-35986 MN

Addresses

Primary practice location

35 Haver Rd
Olivebridge, NY 12461-5007

Mailing address

35 Haver Rd
Olivebridge, NY 12461-5007
Phone (201) 616-9263

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210415000022 GA Practitioner - Clinical Social Worker 1658311279 Practice locations: Savannah, GA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18 E 61St St
Savannah, GA 31405-4116
Phone (201) 616-9263

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CSW007658GAMDClinical Social Worker
LICSW-35986MNMDClinical Social Worker
R079976NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Living Process Counseling Services Co Clinical CurrentSince Dec 21, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1298592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1791072000000",
    "number": "1194022293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 HAVER RD",
            "city": "OLIVEBRIDGE",
            "state": "NY",
            "postal_code": "124615007",
            "telephone_number": "201-616-9263",
            "fax_number": "912-219-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 HAVER RD",
            "city": "OLIVEBRIDGE",
            "state": "NY",
            "postal_code": "124615007",
            "telephone_number": "201-616-9263",
            "fax_number": "912-219-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHN",
        "first_name": "PAUL",
        "middle_name": "WYANT",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-02-25",
        "last_updated": "2026-10-04",
        "certification_date": "2026-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW007658",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R079976",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "LICSW-35986",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olivebridge, NY

Sources for this page

Verify at the official NPI Registry.