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General NPI Number Information
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NPI Number | 1689898892
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Entity Type | Individual
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Provider Name | LAURIE DEPAOLA L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 10/14/2010
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Provider Practice Location Address
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Address Line | 20 YORK ST YALE PSYCHIATRIC HOSPITAL
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City | NEW HAVEN
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State | CT
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Zip | 06510-3220
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Country | US
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Telephone | 203-688-9754
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Fax | 203-688-9744
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Provider Business Mailing Address
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Address Line | 1825 RIDGE RD
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City | NORTH HAVEN
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State | CT
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Zip | 06473-2020
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Country | US
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Telephone | 203-605-7137
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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 | 005472
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License Number State | CT
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