Healthcare Provider Details

I. General information

NPI: 1295229656
Provider Name (Legal Business Name): KAITLIN ELIZABETH HOJNOWSKI LISW- CP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAITLIN ELIZABETH GALAMBOS

II. Dates (important events)

Enumeration Date: 06/19/2018
Last Update Date: 04/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1608 MAIN ST
CONWAY SC
29526-3572
US

IV. Provider business mailing address

1708 OAK ST
CONWAY SC
29526-3086
US

V. Phone/Fax

Practice location:
  • Phone: 834-248-4700
  • Fax:
Mailing address:
  • Phone: 843-488-6363
  • Fax: 843-488-1063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number12658
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: