| Kelly Tarascio, Lcsw, Llc | |
|
72 N Elm St Apt 2b Canaan CT 06018-2162 | |
| (203) 558-0056 | |
| Not Available |
| Full Name | Kelly Tarascio, Lcsw, Llc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 72 N Elm St Apt 2b, Canaan, Connecticut |
| Authorized Official Name and Position | Kelly Tarascio (OWNER) |
| Authorized Official Contact | 2035580056 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Tarascio, Lcsw, Llc 72 N Elm St Apt 2b Canaan CT 06018-2162 Ph: (203) 558-0056 | Kelly Tarascio, Lcsw, Llc 72 N Elm St Apt 2b Canaan CT 06018-2162 Ph: (203) 558-0056 |
| NPI Number | 1114749827 |
|---|---|
| Provider Enumeration Date | 10/25/2024 |
| Last Update Date | 10/28/2024 |
| Certification Date | 10/28/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114749827 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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