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General NPI Number Information
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NPI Number | 1801302096
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Entity Type | Individual
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Provider Name | CARA MEDINA LICSW
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Gender | Female
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Dates
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Enumeration Date | 12/26/2017
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 387 LITCHFIELD ST
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City | TORRINGTON
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State | CT
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Zip | 06790-6602
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Country | US
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Telephone | 860-480-7740
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Fax |
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Provider Business Mailing Address
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Address Line | 37 HOLT RD
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City | HOLDEN
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State | MA
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Zip | 01520-1215
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Country | US
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Telephone | 203-767-7464
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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 | 122289
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License Number State | MA
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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 |
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License Number State | CT
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