Provider Demographics
NPI:1649335779
Name:SENSENIG, HOLLY P (LCSW)
Entity type:Individual
Prefix:
First Name:HOLLY
Middle Name:P
Last Name:SENSENIG
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 1:19 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-1725
Mailing Address - Country:US
Mailing Address - Phone:607-771-3055
Mailing Address - Fax:607-724-5017
Practice Address - Street 1:19 BEACON ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-1725
Practice Address - Country:US
Practice Address - Phone:607-771-3055
Practice Address - Fax:607-724-5017
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
NYR043524-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
159051OtherCDPHP INSURANCE
NY125454OtherBLUE CROSS BLUE SHIELD
NY7480897OtherVALUE OPTIONS
NY953187OtherMVP HEALTH
7529427OtherAETNA HEALTH INSURANCE
7529427OtherAETNA HEALTH INSURANCE