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General NPI Number Information
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NPI Number | 1164646881
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Entity Type | Organization
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Legal Business Name | HOLLOW HILLS COUNSELING CENTER
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 31 MELROSE RD
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City | DIX HILLS
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State | NY
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Zip | 11746-5610
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Country | US
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Telephone | 631-425-1168
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Fax |
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Provider Business Mailing Address
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Address Line | 31 MELROSE RD
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City | DIX HILLS
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State | NY
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Zip | 11746-5610
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Country | US
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Telephone | 631-425-1168
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. MARILYN BETH FENTY
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Credential | RN COUNSELOR
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Telephone | 631-425-1168
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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 | 05-4186-R
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License Number State | NY
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