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General NPI Number Information
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NPI Number | 1013313717
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Entity Type | Organization
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Legal Business Name | HOLLIE BARKOFF LCSW, LLC
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Dates
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Enumeration Date | 11/07/2014
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Last Update Date | 11/07/2014
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Provider Practice Location Address
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Address Line | 45 S MAIN ST SUITE 107
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City | WEST HARTFORD
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State | CT
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Zip | 06107-2441
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Country | US
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Telephone | 860-463-4243
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Fax |
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Provider Business Mailing Address
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Address Line | 30 BASSWOOD RD
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City | FARMINGTON
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State | CT
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Zip | 06032-1134
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Country | US
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Telephone | 860-463-4243
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Fax |
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Authorized Official
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Title or Position | CLINICAL SOCIAL WORKER
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Name | HOLLIE BARKOFF
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Credential | LCSW
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Telephone | 860-463-4243
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 004221
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License Number State | CT
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