Individual
ELLEN HERNANDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
56 ARBOR ST STE 215, HARTFORD, CT 06106-1201
(860) 233-1345
(860) 233-1346
Mailing address
11 BARTON HILL RD, EAST HAMPTON, CT 06424-1130
(860) 478-2229
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
005014
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11242719
CAQH
CT
01
—
140005014CT02
ANTHEM BEHAVIORAL HEALTH
CT
01
—
P3513598
OXFORD
CT
Enumeration date
10/23/2006
Last updated
07/08/2007
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