Healthcare Provider Details

I. General information

NPI: 1326852823
Provider Name (Legal Business Name): JOSEPHINE PAULA SANSEVERINO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/04/2025
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94 CONNECTICUT BLVD
EAST HARTFORD CT
06108-3013
US

IV. Provider business mailing address

5 LYNN AVE
TERRYVILLE CT
06786-5020
US

V. Phone/Fax

Practice location:
  • Phone: 860-528-1359
  • Fax: 860-528-1359
Mailing address:
  • Phone: 203-578-5333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number7372
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: