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General NPI Number Information
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NPI Number | 1033508445
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Entity Type | Individual
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Provider Name | EVA HERNANDEZ-GOLEY LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/22/2015
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Last Update Date | 10/13/2020
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Provider Practice Location Address
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Address Line | 719 W NYACK RD
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City | WEST NYACK
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State | NY
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Zip | 10994-2240
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Country | US
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Telephone | 917-428-6177
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Fax |
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Provider Business Mailing Address
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Address Line | 719 W NYACK RD STE 43
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City | WEST NYACK
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State | NY
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Zip | 10994-2241
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Country | US
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Telephone | 917-428-6177
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 079883-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 083247-1
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License Number State | NY
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