Provider Demographics
NPI:1023306552
Name:KANE, GERARD DANIEL (MSW, C-CATODSW, LADC)
Entity type:Individual
Prefix:MR
First Name:GERARD
Middle Name:DANIEL
Last Name:KANE
Suffix:
Gender:M
Credentials:MSW, C-CATODSW, LADC
Other - Prefix:MR
Other - First Name:GERRY
Other - Middle Name:DANIEL
Other - Last Name:KANE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW, C-CATODSW, LAD
Mailing Address - Street 1:46 DANBURY RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-3403
Mailing Address - Country:US
Mailing Address - Phone:860-355-1122
Mailing Address - Fax:860-355-1122
Practice Address - Street 1:46 DANBURY RD
Practice Address - Street 2:SUITE 2
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-3403
Practice Address - Country:US
Practice Address - Phone:860-355-1122
Practice Address - Fax:860-355-1122
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-19
Last Update Date:2011-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000666101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)