| Kimberly A. Hostig Licensed Clinical Social Worker Pllc | |
|
8 Stanley Cir Ste 11 Latham NY 12110 | |
| (518) 222-6752 | |
| (518) 786-0917 |
| Full Name | Kimberly A. Hostig Licensed Clinical Social Worker Pllc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8 Stanley Cir Ste 11, Latham, New York |
| Authorized Official Name and Position | Kimberly A. Hostig (SOLE OWNER) |
| Authorized Official Contact | 5182226752 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly A. Hostig Licensed Clinical Social Worker Pllc 22 Hampton Cir Mechanicville NY 12118-3436 Ph: (518) 423-6831 | Kimberly A. Hostig Licensed Clinical Social Worker Pllc 8 Stanley Cir Ste 11 Latham NY 12110 Ph: (518) 222-6752 |
| NPI Number | 1114410701 |
|---|---|
| Provider Enumeration Date | 06/08/2018 |
| Last Update Date | 07/24/2018 |
| Medicare PECOS PAC ID | 7416206446 |
|---|---|
| Medicare Enrollment ID | O20180823002038 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114410701 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | R075574-1 (New York) | Primary |
| Provider Name | Kimberly A Hostig |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861478786 PECOS PAC ID: 1456601285 Enrollment ID: I20180829000798 |
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