Healthcare Provider Details

I. General information

NPI: 1710892674
Provider Name (Legal Business Name): ZOE EKATERINI SERNYAK MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 MAIN ST
WILLIMANTIC CT
06226-1940
US

IV. Provider business mailing address

1320 MAIN ST
WILLIMANTIC CT
06226-1940
US

V. Phone/Fax

Practice location:
  • Phone: 860-450-7583
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number11747
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: