Healthcare Provider Details

I. General information

NPI: 1639905417
Provider Name (Legal Business Name): ANGELA HUTCHINS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2024
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 LEDGEBROOK DR STE C
MANSFIELD CENTER CT
06250-1644
US

IV. Provider business mailing address

910 POMFRET RD
HAMPTON CT
06247-1215
US

V. Phone/Fax

Practice location:
  • Phone: 860-833-2657
  • Fax:
Mailing address:
  • Phone: 860-450-6561
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10363
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: