| Michelle M Gienau, Lcsw, Llc | |
|
19 Halls Rd # 234 Old Lyme CT 06371-1457 | |
| (860) 434-5398 | |
| (860) 434-5473 |
| Full Name | Michelle M Gienau, Lcsw, Llc |
|---|---|
| Speciality | Social Worker |
| Location | 19 Halls Rd, Old Lyme, Connecticut |
| Authorized Official Name and Position | Michelle Gienau (OWNER) |
| Authorized Official Contact | 8603344125 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle M Gienau, Lcsw, Llc Po Box 122 Yantic CT 06389-0122 Ph: () - | Michelle M Gienau, Lcsw, Llc 19 Halls Rd # 234 Old Lyme CT 06371-1457 Ph: (860) 434-5398 |
| NPI Number | 1568993046 |
|---|---|
| Provider Enumeration Date | 03/25/2017 |
| Last Update Date | 03/25/2017 |
| Medicare PECOS PAC ID | 3375808553 |
|---|---|
| Medicare Enrollment ID | O20180518000954 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568993046 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 9677 (Connecticut) | Primary |
| Provider Name | Michelle Gienau |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023553807 PECOS PAC ID: 6204119902 Enrollment ID: I20170202002500 |
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