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Organization
KENSHO PSYCHOTHERAPY, LCSW, PLLC
Active
Organization
KENSHO PSYCHOTHERAPY, LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. AMANDA FLUDD LCSW-R (OWNER)
(718) 208-3914
Entity
Organization
Contact information
Practice address
381 SUNRISE HWY STE 602, LYNBROOK, NY 11563-3006
(347) 868-7813
Mailing address
14410 256TH ST, ROSEDALE, NY 11422-2543
(718) 208-3914
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184822587
—
NY
01
—
938144
BEACON
NY
Enumeration date
02/06/2019
Last updated
06/24/2021
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