Basic Information
Provider Information
NPI: 1497968192
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAYNE
FirstName: HARVEY
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: PHD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 798 RAVINE DR
Address2:  
City: YOUNGSTOWN
State: OH
PostalCode: 44505
CountryCode: US
TelephoneNumber: 3307932487
FaxNumber: 3307592802
Practice Location
Address1: 940 WINDHAM COURT
Address2: SUITE 6
City: YOUNGSTOWN
State: OH
PostalCode: 44512
CountryCode: US
TelephoneNumber: 3307932487
FaxNumber: 3307592802
Other Information
ProviderEnumerationDate: 05/08/2007
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700X2551OHY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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