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General NPI Number Information
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NPI Number | 1003101767
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Entity Type | Organization
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Legal Business Name | STEPHANIE PAUL, L.C.S.W. LLC
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Dates
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Enumeration Date | 06/10/2011
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Last Update Date | 06/10/2011
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Provider Practice Location Address
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Address Line | 318 MAIN ST
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City | FARMINGTON
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State | CT
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Zip | 06032-2961
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Country | US
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Telephone | 860-818-1719
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Fax |
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Provider Business Mailing Address
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Address Line | 190 ELLWOOD RD
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City | KENSINGTON
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State | CT
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Zip | 06037-2761
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Country | US
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Telephone | 860-818-1719
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | MS. STEPHANIE S PAUL
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Credential | L.C.S.W.
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Telephone | 860-818-1719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 006933
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License Number State | CT
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