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General NPI Number Information
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NPI Number | 1639952682
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Entity Type | Organization
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Legal Business Name | RELATIONAL ABUSE RESOURCE CENTER LLC
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Dates
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Enumeration Date | 08/15/2023
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Last Update Date | 08/15/2023
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Provider Practice Location Address
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Address Line | 180 POST RD E STE 208
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City | WESTPORT
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State | CT
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Zip | 06880-3414
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Country | US
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Telephone | 203-306-5855
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Fax |
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Provider Business Mailing Address
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Address Line | 4 JARVIS ST
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City | NORWALK
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State | CT
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Zip | 06851-2824
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Country | US
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Telephone | 203-306-5855
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | ELISA LEDERER
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Credential |
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Telephone | 203-306-5855
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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 |
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License Number State |
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