Individual
MS. KIM NOVAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
26 LAKEVIEW ST, EAST HAMPTON, CT 06424-1200
(860) 365-5249
(860) 365-5249
Mailing address
PO BOX 298, EAST HAMPTON, CT 06424-0298
(860) 365-5249
(860) 365-5249
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005111
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004239548-00
—
CT
01
—
486904
VALUE OPTIONS
VA
Enumeration date
01/15/2006
Last updated
01/05/2016
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