Healthcare Provider Details

I. General information

NPI: 1609549252
Provider Name (Legal Business Name): ADLEEN CARRION-SANTOS MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2021
Last Update Date: 07/29/2021
Certification Date: 07/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 MAIN ST FL 3
NEW BRITAIN CT
06051-4206
US

IV. Provider business mailing address

233 MAIN ST FL 3
NEW BRITAIN CT
06051-4206
US

V. Phone/Fax

Practice location:
  • Phone: 860-224-8192
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: