| Hollow Hills Licensed Clinical Social Work P.c. | |
|
31 Melrose Rd Dix Hills NY 11746-5610 | |
| (631) 425-1168 | |
| (631) 673-0313 |
| Full Name | Hollow Hills Licensed Clinical Social Work P.c. |
|---|---|
| Speciality | Social Worker |
| Location | 31 Melrose Rd, Dix Hills, New York |
| Authorized Official Name and Position | William Patrick Fenty (PRESIDENT) |
| Authorized Official Contact | 6314251168 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hollow Hills Licensed Clinical Social Work P.c. 31 Melrose Rd Dix Hills NY 11746-5610 Ph: (631) 425-1168 | Hollow Hills Licensed Clinical Social Work P.c. 31 Melrose Rd Dix Hills NY 11746-5610 Ph: (631) 425-1168 |
| NPI Number | 1346495710 |
|---|---|
| Provider Enumeration Date | 11/26/2008 |
| Last Update Date | 12/03/2008 |
| Medicare PECOS PAC ID | 8123183423 |
|---|---|
| Medicare Enrollment ID | O20090220000328 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346495710 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 104100000X | Social Worker | R054186-1 (New York) | Primary |
| Provider Name | William P Fenty |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1730303454 PECOS PAC ID: 0446315733 Enrollment ID: I20090220000289 |
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Life Stages Counseling Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 14 Candlewood Path, Dix Hills, NY 11746 Phone: 631-327-2508 | |
Hollow Hills Counseling Center Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 31 Melrose Rd, Dix Hills, NY 11746 Phone: 631-425-1168 |