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General NPI Number Information
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NPI Number | 1821404443
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Entity Type | Individual
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Provider Name | THERESA HOCKENSMITH
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Gender | Female
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Dates
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Enumeration Date | 07/02/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 200 W LOWRY LN
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City | LEXINGTON
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State | KY
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Zip | 40503-3019
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Country | US
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Telephone | 859-278-1814
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Fax | 859-276-5206
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Provider Business Mailing Address
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Address Line | 134 HALL ST
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City | HAZARD
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State | KY
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Zip | 41701-1332
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Country | US
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Telephone | 859-361-0460
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Fax | 859-276-5206
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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 | 252453
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License Number State | KY
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