Healthcare Provider Details

I. General information

NPI: 1730225087
Provider Name (Legal Business Name): HEATHER K HOBBS CLINICAL SOCIAL WORK
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER K HOBBS LCSW-R

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 W 34TH ST PENTHOUSE
NEW YORK NY
10001-3006
US

IV. Provider business mailing address

19 W 34TH ST PENTHOUSE
NEW YORK NY
10001-3006
US

V. Phone/Fax

Practice location:
  • Phone: 917-449-3040
  • Fax:
Mailing address:
  • Phone: 917-449-3040
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR050832-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: