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General NPI Number Information
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NPI Number | 1841531878
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Entity Type | Individual
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Provider Name | ELLEN M WRIGHT MSW,BA,LCSW,LMSW,RN
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Gender | Female
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Dates
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Enumeration Date | 03/15/2013
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Last Update Date | 09/08/2016
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Provider Practice Location Address
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Address Line | 141 E MAIN ST WATERBURY CLINICAL SERVICES 2ND FLOOR
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City | WATERBURY
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State | CT
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Zip | 06702-2310
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Country | US
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Telephone | 203-723-9599
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Fax | 293-723-9890
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Provider Business Mailing Address
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Address Line | 141 E MAIN ST 4TH FLOOR ADMINISTRATION
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City | WATERBURY
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State | CT
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Zip | 06702-2310
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Country | US
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Telephone | 203-574-9000
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Fax | 203-574-9006
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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 | 1649
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | E43376
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 9474
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License Number State | CT
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