| Dream Wise, Llc | |
|
290 Pratt Street Meriden CT 06450-8600 | |
| (203) 910-8079 | |
| (203) 405-5803 |
| Full Name | Dream Wise, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 290 Pratt Street, Meriden, Connecticut |
| Authorized Official Name and Position | Natacha Kerelejza (OWNER) |
| Authorized Official Contact | 2039108079 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dream Wise, Llc Po Box 1907 Meriden CT 06450-7059 Ph: (203) 910-8079 | Dream Wise, Llc 290 Pratt Street Meriden CT 06450-8600 Ph: (203) 910-8079 |
| NPI Number | 1376064436 |
|---|---|
| Provider Enumeration Date | 06/29/2017 |
| Last Update Date | 05/03/2021 |
| Certification Date | 05/03/2021 |
| Medicare PECOS PAC ID | 7113283797 |
|---|---|
| Medicare Enrollment ID | O20171115000484 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376064436 | NPI | - | NPPES |
| 008072080 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 006421 (Connecticut) | Primary |
| Provider Name | Natacha Jaboin Kerelejza |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235670035 PECOS PAC ID: 8022374602 Enrollment ID: I20171115000862 |
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