Healthcare Provider Details

I. General information

NPI: 1841048329
Provider Name (Legal Business Name): NATALIE ANN ST MARTIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2024
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

54 MORTIMER ST
TORRINGTON CT
06790-6818
US

IV. Provider business mailing address

54 MORTIMER ST
TORRINGTON CT
06790-6818
US

V. Phone/Fax

Practice location:
  • Phone: 203-450-9847
  • Fax:
Mailing address:
  • Phone: 203-887-5036
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06661100
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16319
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number29989
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6723
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: