| Stephanie Harris Lcsw Ladc Llc | |
|
609 W Johnson Ave Ste 310 Cheshire CT 06410-4505 | |
| (203) 600-2951 | |
| Not Available |
| Full Name | Stephanie Harris Lcsw Ladc Llc |
|---|---|
| Speciality | Social Worker |
| Location | 609 W Johnson Ave Ste 310, Cheshire, Connecticut |
| Authorized Official Name and Position | Stephanie Harris (OWNER) |
| Authorized Official Contact | 2036002951 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Stephanie Harris Lcsw Ladc Llc 609 W Johnson Ave Ste 310 Cheshire CT 06410-4505 Ph: (203) 600-2951 | Stephanie Harris Lcsw Ladc Llc 609 W Johnson Ave Ste 310 Cheshire CT 06410-4505 Ph: (203) 600-2951 |
| NPI Number | 1780303321 |
|---|---|
| Provider Enumeration Date | 08/25/2022 |
| Last Update Date | 08/25/2022 |
| Certification Date | 08/25/2022 |
| Medicare PECOS PAC ID | 3779952445 |
|---|---|
| Medicare Enrollment ID | O20221220001267 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780303321 | NPI | - | NPPES |
| 11409 | Other | CT | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stephanie Lynn Harris |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225261951 PECOS PAC ID: 2668880162 Enrollment ID: I20210422000814 |
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