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General NPI Number Information
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NPI Number | 1578625067
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Entity Type | Organization
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Legal Business Name | ICES INC.
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 01/23/2015
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Provider Practice Location Address
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Address Line | 35 ELM ST
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City | NAUGATUCK
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State | CT
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Zip | 06770-4127
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Country | US
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Telephone | 203-723-4133
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Fax | 203-723-4202
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Provider Business Mailing Address
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Address Line | 35 ELM ST
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City | NAUGATUCK
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State | CT
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Zip | 06770-4127
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Country | US
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Telephone | 203-723-4133
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Fax | 203-723-4202
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Authorized Official
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Title or Position | DIRECTOR OF CLINICAL SERVICES
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Name | MS. STACY MARIE PROPFE
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Credential | LCSW
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Telephone | 203-723-4133
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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 | 004892
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License Number State | CT
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