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General NPI Number Information
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NPI Number | 1023512407
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Entity Type | Organization
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Legal Business Name | AMANDA FRECHETTE, LCSW LLC
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Dates
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Enumeration Date | 03/21/2018
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Last Update Date | 03/21/2018
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Provider Practice Location Address
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Address Line | 567 VAUXHALL STREET EXT STE 315
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City | WATERFORD
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State | CT
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Zip | 06385-4341
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Country | US
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Telephone | 860-389-1208
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Fax |
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Provider Business Mailing Address
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Address Line | 7 TWIN LAKES DR
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City | WATERFORD
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State | CT
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Zip | 06385-4111
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Country | US
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Telephone | 860-389-1208
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Fax |
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Authorized Official
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Title or Position | CLINICIAN II
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Name | AMANDA ELIZABETH FRECHETTE
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Credential | LCSW
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Telephone | 860-389-1208
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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 | 8693
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License Number State | CT
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