Provider Demographics
NPI:1992015838
Name:GALVAN-HENKIN, LLC
Entity Type:Organization
Organization Name:GALVAN-HENKIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:SANDRA
Authorized Official - Last Name:GALVAN-HENKIN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:203-255-2680
Mailing Address - Street 1:4 TODDS WAY
Mailing Address - Street 2:
Mailing Address - City:WESTPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06880-5645
Mailing Address - Country:US
Mailing Address - Phone:203-255-2680
Mailing Address - Fax:203-255-2602
Practice Address - Street 1:4 TODDS WAY
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-5645
Practice Address - Country:US
Practice Address - Phone:203-255-2680
Practice Address - Fax:203-255-2602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-10-13
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT25321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTP2556023OtherOXFORD HEALTH PLANS
CT140002532CT01OtherANTHEM BLUE CROSS BLUE SHIELD
CT800000461Medicare PIN