MEDICARE: MRS. LEAH COHEN BEMILLER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	MSW.002306	CT
2	104100000X	Social Worker	LCSW10256	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1326416975
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LEAH COHEN BEMILLER LCSW

Provider Business Mailing Address
First Line	:	225 N MAIN ST STE 106
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-4993
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	225 N MAIN ST STE 106
Second Line	:
City	:	BRISTOL
State	:	CT
Zip	:	06010-4993
Country	:	US
Telephone Number	:	860-793-3500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2015
Last Update Date	:	02/11/2020

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