Provider Demographics
NPI:1255748893
Name:LONGAKER, KIRANJIT KAUR (LMHC)
Entity type:Individual
Prefix:MS
First Name:KIRANJIT
Middle Name:KAUR
Last Name:LONGAKER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 E STATE ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4400
Mailing Address - Country:US
Mailing Address - Phone:607-592-6539
Mailing Address - Fax:607-697-2400
Practice Address - Street 1:401 E STATE ST
Practice Address - Street 2:SUITE 400
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4400
Practice Address - Country:US
Practice Address - Phone:607-592-6539
Practice Address - Fax:607-697-2400
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-15
Last Update Date:2016-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006416101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health