Healthcare Provider Details

I. General information

NPI: 1588614408
Provider Name (Legal Business Name): VALERIE K HOTCHKISS LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2006
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

229-231 STATE ST
BINGHAMTON NY
13901-2756
US

IV. Provider business mailing address

5212 BOW BRIDGE RD
FRIENDSVILLE PA
18818-8825
US

V. Phone/Fax

Practice location:
  • Phone: 607-778-1192
  • Fax: 607-228-1164
Mailing address:
  • Phone: 570-553-2086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberR059339-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: