Healthcare Provider Details

I. General information

NPI: 1689744716
Provider Name (Legal Business Name): ARPINE APKAR HOVAGUIMIAN LCSW-R
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 01/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 E STATE ST STE 201
ITHACA NY
14850-4400
US

IV. Provider business mailing address

401 E STATE ST STE 201
ITHACA NY
14850-4400
US

V. Phone/Fax

Practice location:
  • Phone: 607-319-4774
  • Fax: 607-272-1927
Mailing address:
  • Phone: 607-319-4774
  • Fax: 607-272-1927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberR053885-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR053885-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: