Provider Demographics
NPI:1053476150
Name:LIENGHOT, HAKIN (LICSW)
Entity Type:Individual
Prefix:
First Name:HAKIN
Middle Name:
Last Name:LIENGHOT
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 PINEHURST RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:RI
Mailing Address - Zip Code:02915-1410
Mailing Address - Country:US
Mailing Address - Phone:401-433-0147
Mailing Address - Fax:508-999-7795
Practice Address - Street 1:50 N 2ND ST
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740-6249
Practice Address - Country:US
Practice Address - Phone:508-997-6091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1074031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical