Healthcare Provider Details

I. General information

NPI: 1629603402
Provider Name (Legal Business Name): ELENA KATHERINE WOODARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELENA KATHERINE HILL

II. Dates (important events)

Enumeration Date: 03/11/2020
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 HAZARD AVE STE 23
ENFIELD CT
06082-3713
US

IV. Provider business mailing address

14 HAZARD AVE STE 23
ENFIELD CT
06082-3713
US

V. Phone/Fax

Practice location:
  • Phone: 860-316-4594
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number13123
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: