Provider Demographics
NPI:1730265109
Name:KINN, GAIL SUSAN (LMSW)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:SUSAN
Last Name:KINN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W END AVE APT 5C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5751
Mailing Address - Country:US
Mailing Address - Phone:212-362-3514
Mailing Address - Fax:212-877-7988
Practice Address - Street 1:120 W 57TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3320
Practice Address - Country:US
Practice Address - Phone:212-632-4637
Practice Address - Fax:212-632-4495
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY073301-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical