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General NPI Number Information
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NPI Number | 1578819611
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Entity Type | Individual
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Provider Name | ELENA AMPEIRE LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/26/2012
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Last Update Date | 07/26/2012
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Provider Practice Location Address
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Address Line | 1066 STORRS RD
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City | STORRS
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State | CT
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Zip | 06268-2648
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Country | US
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Telephone | 860-429-2928
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 402
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City | MANSFIELD CTR
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State | CT
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Zip | 06250-0402
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Country | US
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Telephone |
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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 | 007117
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License Number State | CT
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