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General NPI Number Information
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NPI Number | 1386030104
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Entity Type | Individual
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Provider Name | MARIA RAFFIA LCSW, PMH-C
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Gender | Female
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 61 PENDLETON ST # 1
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City | NEW HAVEN
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State | CT
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Zip | 06511-4024
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Country | US
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Telephone | 203-401-8935
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Fax |
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Provider Business Mailing Address
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Address Line | 61 PENDLETON ST APT 1
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City | NEW HAVEN
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State | CT
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Zip | 06511-4024
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Country | US
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Telephone | 203-401-8935
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 010879
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License Number State | CT
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