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NPI Code Detail

MEDICARE: MRS. EMILY KOLKER LCSW

MEDICARE: MRS. EMILY KOLKER LCSW
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
11041C0700XClinical Social Worker078535-1NY

General Provider Information

NPI Number : 1619135746
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. EMILY KOLKER LCSW
Provider Business Mailing Address
First Line : 9 ANTONIO CT
Second Line :
City : CORTLANDT MANOR
State : NY
Zip : 10567-6331
Country : US
Telephone Number : 914-260-0784
Fax Number :
Provider Business Practice Location Address
First Line : 1392 ALBANY POST RD
Second Line : THE LIGHTHOUSE RETREAT AND WELLNESS CENTER
City : CROTON ON HUDSON
State : NY
Zip : 10520-1559
Country : US
Telephone Number : 914-648-0790
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/27/2008
Last Update Date : 10/23/2013

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