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General NPI Number Information
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NPI Number | 1205247897
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Entity Type | Individual
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Provider Name | NICOLE CEPEDA LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/16/2014
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Last Update Date | 02/01/2023
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Provider Practice Location Address
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Address Line | 55 LOCK ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-3603
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Country | US
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Telephone | 203-432-0306
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Fax |
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Provider Business Mailing Address
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Address Line | 92 GROVE ST APT D2
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City | STAMFORD
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State | CT
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Zip | 06901-1849
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Country | US
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Telephone | 347-451-8774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 088267
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License Number State | NY
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