MEDICARE: MS. LEONA HOPKINS L.C.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC04944900	NJ

General Provider Information

NPI Number	:	1558664300
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LEONA HOPKINS L.C.S.W.

Provider Business Mailing Address
First Line	:	25 PITT RD
Second Line	:
City	:	BOONTON
State	:	NJ
Zip	:	07005-9750
Country	:	US
Telephone Number	:	973-335-2028
Fax Number	:

Provider Business Practice Location Address
First Line	:	390 MAIN RD
Second Line	:
City	:	MONTVILLE
State	:	NJ
Zip	:	07045-9785
Country	:	US
Telephone Number	:	973-316-9333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2010
Last Update Date	:	12/17/2010

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