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
Health care specialties
Specialty | Code | License # | 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 7 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1538240346 | NPPES |
Florida | MEDICAID | 761955300 |
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