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General NPI Number Information
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NPI Number | 1619135746
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Entity Type | Individual
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Provider Name | EMILY KOLKER LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 10/23/2013
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Provider Practice Location Address
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Address Line | 1392 ALBANY POST RD THE LIGHTHOUSE RETREAT AND WELLNESS CENTER
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City | CROTON ON HUDSON
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State | NY
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Zip | 10520-1559
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Country | US
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Telephone | 914-648-0790
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Fax |
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Provider Business Mailing Address
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Address Line | 9 ANTONIO CT
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City | CORTLANDT MANOR
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State | NY
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Zip | 10567-6331
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Country | US
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Telephone | 914-260-0784
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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 | 078535-1
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License Number State | NY
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