MEDICARE: ARIANA M CARDOZO 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	1041C0700X	Clinical Social Worker	010288	CT

General Provider Information

NPI Number	:	1336619840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANA M CARDOZO LCSW

Provider Business Mailing Address
First Line	:	165 ELM ST FL 3
Second Line	:
City	:	WINSTED
State	:	CT
Zip	:	06098-1626
Country	:	US
Telephone Number	:	860-866-8859
Fax Number	:

Provider Business Practice Location Address
First Line	:	76 WESTBURY PARK RD
Second Line	:
City	:	WATERTOWN
State	:	CT
Zip	:	06795-2779
Country	:	US
Telephone Number	:	860-866-8859
Fax Number	:

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

Provider Enumeration Date	:	11/27/2018
Last Update Date	:	11/27/2018

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Directions to “ ARIANA M CARDOZO LCSW” Practice Location

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