Healthcare Provider Details

I. General information

NPI: 1174497424
Provider Name (Legal Business Name): NEHEMIE MOISE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2025
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 NATIONAL DR STE 10C
WINDSOR LOCKS CT
06096-1078
US

IV. Provider business mailing address

5 NATIONAL DR STE 10C
WINDSOR LOCKS CT
06096-1078
US

V. Phone/Fax

Practice location:
  • Phone: 203-973-7731
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number015737
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: