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General NPI Number Information
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NPI Number | 1750213500
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Entity Type | Individual
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Provider Name | ELSY ROXANNA SOBERAL-PEREZ LCSW
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Gender |
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 401 SHIPPAN AVE
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City | STAMFORD
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State | CT
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Zip | 06902-6075
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Country | US
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Telephone | 203-324-6127
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Fax | 203-353-1524
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Provider Business Mailing Address
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Address Line | 19 GRAND ST
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City | MIDDLETOWN
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State | CT
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Zip | 06457-2705
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Country | US
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Telephone | 860-347-6971
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Fax | 860-343-7379
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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 | 16661
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License Number State | CT
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