Healthcare Provider Details

I. General information

NPI: 1801804042
Provider Name (Legal Business Name): LAUREN KATE CARDONE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 05/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 NORTH MAIN STREET
DAYVILLE CT
06241-0839
US

IV. Provider business mailing address

24 COLLIER RD
WETHERSFIELD CT
06109-3524
US

V. Phone/Fax

Practice location:
  • Phone: 860-228-4480
  • Fax:
Mailing address:
  • Phone: 860-965-2529
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number047385351
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: