Fasshauer, Kirk D

Fasshauer, Kirk D is an individual health care provider with primary practice located at 1255 Golfview Ave , Bartow FL 33830-6736. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Fasshauer, Kirk D can be contacted via phone (863) 519-0575.

Contact Information

Primary practice address
1255 Golfview Ave Bartow FL 33830-6736
Phone: (863) 519-0575
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X SW15228 Florida

Profile Details

NPI number 1538240346
LBN Legal business name Fasshauer, Kirk D
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2006
Last updated Mar 28th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538240346 NPPES
Florida MEDICAID 761955300

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