Healthcare Provider Details

I. General information

NPI: 1841693199
Provider Name (Legal Business Name): LISA ANN HOTCHKISS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2014
Last Update Date: 11/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3360 ROUTE 343
AMENIA NY
12501-5619
US

IV. Provider business mailing address

PO BOX 5036
WHITE PLAINS NY
10602-5036
US

V. Phone/Fax

Practice location:
  • Phone: 845-838-7038
  • Fax: 845-373-6028
Mailing address:
  • Phone: 845-838-7038
  • Fax: 845-373-6028

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number087842-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number084773
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: