Provider Demographics
NPI:1063020592
Name:HORN, OLIVIA (LCSW)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:HORN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 PONDSIDE LN
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-1146
Mailing Address - Country:US
Mailing Address - Phone:860-294-9291
Mailing Address - Fax:
Practice Address - Street 1:60 PONDSIDE LN
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-1146
Practice Address - Country:US
Practice Address - Phone:860-294-9291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-21
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0109361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical