Provider Demographics
NPI:1730212333
Name:GREENBERG, KALMAN KENNETH (LMHC)
Entity type:Individual
Prefix:
First Name:KALMAN
Middle Name:KENNETH
Last Name:GREENBERG
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:KENNETH
Other - Middle Name:
Other - Last Name:GREENBERG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:1274 49TH ST
Mailing Address - Street 2:SUITE 256
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3011
Mailing Address - Country:US
Mailing Address - Phone:917-520-4738
Mailing Address - Fax:718-504-4895
Practice Address - Street 1:1360 48TH ST
Practice Address - Street 2:C5
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-5262
Practice Address - Country:US
Practice Address - Phone:917-520-4738
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003693-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health