Doctor Name: | MRS. COLLEEN GOLDEN-BOCK |
NPI Number: | 1023430188 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW, ACSW, ACHP-SW |
License Number: | 73-075544 |
Business Practice Address: | 1983 Marcus Ave New Hyde Park, NY - 110422000 |
Business Phone Number: | 5166627135 |
Business Fax Number: | |
Mailing Address: | 25 Bartlett Dr, MANHASSET |
State: | NY |
Postal Code: | 110302120 |
Phone Number: | 5166627135 |
Fax Number: | |
NPI Enumeration Date: | 01/09/2014 |
NPI Last Update Date: | 01/09/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 73-075544 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |