Healthcare Provider Details

I. General information

NPI: 1407094584
Provider Name (Legal Business Name): KAMARA L MCLEOD LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2009
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 HAYNES ST
MANCHESTER CT
06040-4188
US

IV. Provider business mailing address

888 SILVER LN UNIT 380036
HARTFORD CT
06138-7703
US

V. Phone/Fax

Practice location:
  • Phone: 860-647-4417
  • Fax:
Mailing address:
  • Phone: 561-396-6678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number32462
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW11056
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW007508
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number201226
License Number StateAK
# 5
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number14349
License Number StateCT
# 6
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17686
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: