Individual provider Active NPI

Jason Keith Kahn, LCSW-R

  • Clinical Social Worker
  • Nyack, NY
National Provider Identifier
1326325648
Registry record updated Jul 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R070474-01 Issued in NY
Practice address
9 N Mill St Ste 105
Nyack, NY 10960-3015
Phone
(845) 729-4220
NPI assigned
Nov 15, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R070474-01 NY Primary

Addresses

Primary practice location

9 N Mill St Ste 105
Nyack, NY 10960-3015

Mailing address

9 N Mill St Ste 105
Nyack, NY 10960-3015
Phone (845) 729-4220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R070474-01NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1321315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690156800000",
    "number": "1326325648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 N MILL ST STE 105",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109603015",
            "telephone_number": "845-729-4220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 N MILL ST STE 105",
            "city": "NYACK",
            "state": "NY",
            "postal_code": "109603015",
            "telephone_number": "845-729-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAHN",
        "first_name": "JASON",
        "middle_name": "KEITH",
        "name_prefix": "Mr.",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-15",
        "last_updated": "2023-07-24",
        "certification_date": "2022-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R070474-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nyack, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2023; 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.