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General NPI Number Information
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NPI Number | 1659742674
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Entity Type | Organization
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Legal Business Name | DENISE HEIMBROCK LCSW LLC
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Dates
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Enumeration Date | 10/16/2015
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Last Update Date | 10/16/2015
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Provider Practice Location Address
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Address Line | 7 OLD SHERMAN TPKE SUITE 102
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City | DANBURY
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State | CT
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Zip | 06810-4174
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Country | US
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Telephone | 203-598-5405
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Fax | 203-205-0920
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Provider Business Mailing Address
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Address Line | 7 OLD SHERMAN TPKE SUITE 102
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City | DANBURY
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State | CT
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Zip | 06810-4174
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Country | US
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Telephone | 203-598-5405
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Fax | 203-205-0920
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Authorized Official
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Title or Position | OWNER
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Name | MRS. DENISE BRAHMANN HEIMBROCK
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Credential | LCSW
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Telephone | 203-598-5405
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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 | 5884
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License Number State | CT
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