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General NPI Number Information
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NPI Number | 1124649298
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Entity Type | Individual
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Provider Name | HALI VACLAVIK LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/30/2020
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 214C PROVIDENCE RD
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City | BROOKLYN
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State | CT
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Zip | 06234-1833
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Country | US
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Telephone | 860-351-3363
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Fax | 860-407-3786
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Provider Business Mailing Address
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Address Line | 20 CLEAR VIEW DR
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City | BROOKLYN
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State | CT
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Zip | 06234-2016
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Country | US
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Telephone | 401-230-2770
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Fax | 860-407-3786
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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 | 11101
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License Number State | CT
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