Kensho Psychotherapy, LCSW, PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KENSHO PSYCHOTHERAPY, LCSW, PLLC

Practice address

381 Sunrise Hwy Ste 602
Lynbrook, NY 11563-3006

Phone

(347) 868-7813

NPI assigned

Feb 6, 2019

Last updated

Jun 24, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Amanda Fludd, LCSW-RNPI 1184822587

Title

Owner

Phone

(718) 208-3914

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amanda Fludd, LCSW

  • Clinical Social Worker
  • Lynbrook, NY
  • NPI 1184822587
  NPD Authorized official

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

{
    "created_epoch": "1549411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624492800000",
    "number": "1205391018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14410 256TH ST",
            "city": "ROSEDALE",
            "state": "NY",
            "postal_code": "114222543",
            "telephone_number": "718-208-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "381 SUNRISE HWY STE 602",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115633006",
            "telephone_number": "347-868-7813"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41A W Merrick Rd Ste 2",
            "address_purpose": "LOCATION",
            "city": "Valley Stream",
            "state": "NY",
            "postal_code": "115805708",
            "country_code": "US",
            "telephone_number": "347-868-7813",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KENSHO PSYCHOTHERAPY, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-06",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A",
        "authorized_official_last_name": "FLUDD",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-208-3914",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1184822587",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON",
            "identifier": "938144",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Francine Gnoffo Keogh
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• Mussarah Khan

• Clinical Social Worker in Lynbrook, NY
• Providers in Lynbrook, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.