Cassidy A Khan, LMSW
Individual provider Active NPI Clinical Social Worker · Tuckahoe, NY
NPI 1508527953 · NPPES record last updated Jan 7, 2022
Key facts
- NPI
- 1508527953
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 109968 (NY)
- Practice address
- 121 Fisher Ave Apt F1
Tuckahoe, NY 10707-2615 - Phone
- (917) 391-8691
- NPI assigned
- Jan 7, 2022
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 109968 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 109968 | NY | Yes |
Addresses
Primary practice location
121 Fisher Ave Apt F1
Tuckahoe, NY 10707-2615
Mailing address
121 Fisher Ave Apt F1
Tuckahoe, NY 10707-2615
Phone (917) 391-8691
Other providers in Tuckahoe, NY
- Ardith Inlaw
- Nicholas Vincent Isabella III
- Monique Johnson
- Jonathan David, MD, PC
- Jonathan Leo Kerz
- Vivian Khedari Depierro
- Sung Jae Kim
- Alesha Kittrell-Mobley
- Victoria Klotz
- Helen Teresa Kuznicki
All providers in Tuckahoe, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.