MEDICARE: SONIA MASSEY LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	366	CT

General Provider Information

NPI Number	:	1275276883
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SONIA MASSEY LMSW

Provider Business Mailing Address
First Line	:	5 MANSFIELD GROVE RD APT 145
Second Line	:
City	:	EAST HAVEN
State	:	CT
Zip	:	06512-4812
Country	:	US
Telephone Number	:	267-312-5729
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 MANSFIELD GROVE RD APT 145
Second Line	:
City	:	EAST HAVEN
State	:	CT
Zip	:	06512-4812
Country	:	US
Telephone Number	:	267-312-5729
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/20/2022
Last Update Date	:	04/20/2022

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