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General NPI Number Information
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NPI Number | 1669797247
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Entity Type | Individual
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Provider Name | EILEEN MAE MANELA LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/07/2010
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Last Update Date | 04/07/2010
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Provider Practice Location Address
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Address Line | 7 WEST STREET SUITE #26
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City | LITCHFIELD
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State | CT
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Zip | 06759-3822
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Country | US
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Telephone | 860-782-9919
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Fax | 860-782-9919
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Provider Business Mailing Address
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Address Line | 19 BLAKESLEE ROAD
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City | LITCHFIELD
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State | CT
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Zip | 06759-3822
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Country | US
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Telephone | 860-782-9919
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Fax | 860-782-9919
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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 | 006480
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | R035042-1
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License Number State | NY
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