Lycke, Kevin Michael

Lycke, Kevin Michael is an sole proprietor health care provider with primary practice located at 33 Walt Whitman Rd Suite 106, Huntington Station NY 11746-3640. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Lycke, Kevin Michael can be contacted via phone (631) 334-0234.

Contact Information

Primary practice address
33 Walt Whitman Rd Suite 106 Huntington Station NY 11746-3640
Phone: (631) 334-0234
Fax: (631) 981-2679
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X PR065283-1 New York

Profile Details

NPI number 1770894511
LBN Legal business name Lycke, Kevin Michael
Credentials MSW/LCSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 26th, 2010
Last updated Dec 14th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770894511 NPPES
New York MEDICAID 03279229

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