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General NPI Number Information
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NPI Number | 1972676054
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Entity Type | Individual
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Provider Name | ALICIA G. NIETO LICSW
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Gender | Female
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 07/18/2025
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Provider Practice Location Address
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Address Line | 509 WETHERSFIELD AVE
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City | HARTFORD
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State | CT
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Zip | 06114-1907
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Country | US
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Telephone | 860-296-2121
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Fax |
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Provider Business Mailing Address
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Address Line | 29 KELSEY ST
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City | HARTFORD
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State | CT
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Zip | 06106-4337
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Country | US
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Telephone | 860-956-7924
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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 | 004779
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number | 004779
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License Number State | CT
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