Individual provider Active NPI

Jillien Anne Kahn, LMFT, MED, CST

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1770851701
Registry record updated Jan 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
001535 Issued in NY
Practice address
110 Lafayette St RM 501
New York, NY 10013-4116
Phone
(360) 689-4031
NPI assigned
Dec 5, 2011
Last updated
Jan 6, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2020

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 001535 NY Primary

Addresses

Primary practice location

110 Lafayette St RM 501
New York, NY 10013-4116

Mailing address

110 Lafayette St RM 501
New York, NY 10013-4116
Phone (360) 689-4031

Other practice location 1

4760 S. Sepulveda Blvd
Culver City, CA 90230
Phone (310) 390-6612

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
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
001535NYMDClinical Social Worker

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": "1323043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578268800000",
    "number": "1770851701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LAFAYETTE ST RM 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134116",
            "telephone_number": "360-689-4031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LAFAYETTE ST RM 501",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134116",
            "telephone_number": "360-689-4031"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4760 S. Sepulveda Blvd",
            "address_purpose": "LOCATION",
            "city": "Culver City",
            "state": "CA",
            "postal_code": "90230",
            "country_code": "US",
            "telephone_number": "310-390-6612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAHN",
        "first_name": "JILLIEN",
        "middle_name": "ANNE",
        "credential": "LMFT, MED, CST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-12-05",
        "last_updated": "2020-01-06",
        "certification_date": "2020-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "001535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2020; 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.