MEDICARE: KAREN LADR-FINEFROCK 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	390200000X	Student in an Organized Health Care Education/Training Program
2	104100000X	Social Worker

General Provider Information

NPI Number	:	1457629214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LADR-FINEFROCK LCSW

Provider Business Mailing Address
First Line	:	6 DEERFIELD AVE
Second Line	:
City	:	MIDDLETOWN
State	:	CT
Zip	:	06457-5309
Country	:	US
Telephone Number	:	860-638-8404
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 GROVE ST STE 201
Second Line	:
City	:	NEW BRITAIN
State	:	CT
Zip	:	06053-4116
Country	:	US
Telephone Number	:	203-518-5380
Fax Number	:

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

Provider Enumeration Date	:	12/08/2011
Last Update Date	:	04/17/2018

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