MEDICARE: ARIANNA ROSE MORA 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	012729	CT

General Provider Information

NPI Number	:	1588434518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARIANNA ROSE MORA LCSW

Provider Business Mailing Address
First Line	:	31 STONY BROOK DR
Second Line	:
City	:	MONROE
State	:	CT
Zip	:	06468-2417
Country	:	US
Telephone Number	:	203-364-7261
Fax Number	:

Provider Business Practice Location Address
First Line	:	31 STONY BROOK DR
Second Line	:
City	:	MONROE
State	:	CT
Zip	:	06468-2417
Country	:	US
Telephone Number	:	203-364-7261
Fax Number	:

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

Provider Enumeration Date	:	01/02/2024
Last Update Date	:	01/02/2024

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