| Whitehawk, Llc | |
|
26 Lakeview St East Hampton CT 06424-1200 | |
| (860) 365-5249 | |
| (860) 365-5249 |
| Full Name | Whitehawk, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 26 Lakeview St, East Hampton, Connecticut |
| Authorized Official Name and Position | Kim Novak (OWNER) |
| Authorized Official Contact | 8603655249 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Whitehawk, Llc Po Box 298 East Hampton CT 06424-0298 Ph: (860) 365-5249 | Whitehawk, Llc 26 Lakeview St East Hampton CT 06424-1200 Ph: (860) 365-5249 |
| NPI Number | 1992161806 |
|---|---|
| Provider Enumeration Date | 01/07/2016 |
| Last Update Date | 02/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992161806 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 005111 (Connecticut) | Primary |
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