| Effective Community Services Tlc Llc | |
|
419 Whalley Ave Ste 101 New Haven CT 06511-3019 | |
| (203) 439-5555 | |
| Not Available |
| Full Name | Effective Community Services Tlc Llc |
|---|---|
| Speciality | Social Worker |
| Location | 419 Whalley Ave Ste 101, New Haven, Connecticut |
| Authorized Official Name and Position | Lisa Hardy-gardner (OWNER) |
| Authorized Official Contact | 2034395555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Effective Community Services Tlc Llc 73 Fernwood Rd Hamden CT 06517-2915 Ph: () - | Effective Community Services Tlc Llc 419 Whalley Ave Ste 101 New Haven CT 06511-3019 Ph: (203) 439-5555 |
| NPI Number | 1861256497 |
|---|---|
| Provider Enumeration Date | 02/13/2024 |
| Last Update Date | 07/23/2024 |
| Certification Date | 07/23/2024 |
| Medicare PECOS PAC ID | 5496192445 |
|---|---|
| Medicare Enrollment ID | O20240326002117 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861256497 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| 253Z00000X | In Home Supportive Care | (* (Not Available)) | Secondary |
| Provider Name | Danyell Byrd |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1245900497 PECOS PAC ID: 6305233669 Enrollment ID: I20220505000543 |
| Provider Name | Fannie Hardy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699319640 PECOS PAC ID: 6709273063 Enrollment ID: I20220505000756 |
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