| Jerry Kahn Therapy, Llc | |
|
10855 W Potter Rd Ste 28 Wauwatosa WI 53226-3439 | |
| (414) 803-7238 | |
| Not Available |
| Full Name | Jerry Kahn Therapy, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 10855 W Potter Rd Ste 28, Wauwatosa, Wisconsin |
| Authorized Official Name and Position | Jerry M Kahn (LCSW) |
| Authorized Official Contact | 4148037238 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry Kahn Therapy, Llc 10855 W Potter Rd Ste 28 Wauwatosa WI 53226-3439 Ph: (414) 803-7238 | Jerry Kahn Therapy, Llc 10855 W Potter Rd Ste 28 Wauwatosa WI 53226-3439 Ph: (414) 803-7238 |
| NPI Number | 1104591114 |
|---|---|
| Provider Enumeration Date | 08/11/2021 |
| Last Update Date | 11/01/2021 |
| Certification Date | 11/01/2021 |
| Medicare PECOS PAC ID | 2961800164 |
|---|---|
| Medicare Enrollment ID | O20211220001571 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104591114 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Jerry M Kahn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063819803 PECOS PAC ID: 9436359072 Enrollment ID: I20191202000304 |
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