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NPI Code Detail

MEDICARE: THERESA HOCKENSMITH, PLLC

MEDICARE: THERESA HOCKENSMITH, PLLC
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 Worker252453KY

General Provider Information

NPI Number : 1619499159
Entity Type Code : Organization
Provider Name (Legal Business Name) : THERESA HOCKENSMITH, PLLC
Provider Business Mailing Address
First Line : 134 HALL ST
Second Line :
City : HAZARD
State : KY
Zip : 41701-1332
Country : US
Telephone Number : 859-361-0460
Fax Number : 859-276-5206
Provider Business Practice Location Address
First Line : 200 W LOWRY LN
Second Line :
City : LEXINGTON
State : KY
Zip : 40503-3019
Country : US
Telephone Number : 859-278-1814
Fax Number : 859-276-5206
Authorized Official
Title or Position : MANAGER
Name : THERESA HOCKENSMITH
Credential : LCSW
Telephone Number : 859-361-0460
Provider Enumeration Date : 07/15/2017
Last Update Date : 08/02/2017

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