MEDICARE: MR. THOMAS E. NARDUCCI L.C.S.W.

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	002216	CT

General Provider Information

NPI Number	:	1942307137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS E. NARDUCCI L.C.S.W.

Provider Business Mailing Address
First Line	:	PO BOX 411
Second Line	:
City	:	COLLINSVILLE
State	:	CT
Zip	:	06022-0411
Country	:	US
Telephone Number	:	860-693-1044
Fax Number	:	860-489-2604

Provider Business Practice Location Address
First Line	:	409 BANTAM RD STE A1
Second Line	:
City	:	LITCHFIELD
State	:	CT
Zip	:	06759-3200
Country	:	US
Telephone Number	:	860-693-1044
Fax Number	:	860-489-2604

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

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/08/2007

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