Basic Information
Provider Information
NPI: 1043829054
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAHN
FirstName: ALAINA
MiddleName: BREANNE
NamePrefix:  
NameSuffix:  
Credential: LMSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 7474 GREENWAY CENTER DR STE 200
Address2:  
City: GREENBELT
State: MD
PostalCode: 207703524
CountryCode: US
TelephoneNumber: 2403043327
FaxNumber: 4106097091
Practice Location
Address1: 17904 GEORGIA AVE STE 200
Address2:  
City: OLNEY
State: MD
PostalCode: 208322277
CountryCode: US
TelephoneNumber: 2403043327
FaxNumber: 4106097091
Other Information
ProviderEnumerationDate: 07/26/2020
LastUpdateDate: 03/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X25962MDY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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