| Portia Pendleton, Lcsw Llc. | |
|
251 Main St Ste 200 Old Saybrook CT 06475-2357 | |
| (860) 245-9598 | |
| Not Available |
| Full Name | Portia Pendleton, Lcsw Llc. |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 251 Main St Ste 200, Old Saybrook, Connecticut |
| Authorized Official Name and Position | Portia Pendleton (OWNER) |
| Authorized Official Contact | 8607599162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portia Pendleton, Lcsw Llc. 12 Rogers Lake Trl Old Lyme CT 06371-1223 Ph: (860) 759-9162 | Portia Pendleton, Lcsw Llc. 251 Main St Ste 200 Old Saybrook CT 06475-2357 Ph: (860) 245-9598 |
| NPI Number | 1285261156 |
|---|---|
| Provider Enumeration Date | 03/23/2020 |
| Last Update Date | 03/23/2020 |
| Certification Date | 03/23/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285261156 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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