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Individual

ELIZABETH MARY STOCKWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
300 STATE ST STE 503, NEW LONDON, CT 06320-6133
(860) 271-5283
Mailing address
300 STATE ST STE 503, NEW LONDON, CT 06320-6133
(860) 271-5283

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
085263-1
NY
104100000X
Social Worker
217650
MA
1041C0700X
Clinical Social Worker
011946
CT
1041C0700X
Clinical Social Worker
Primary
11946
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008107739
CT
Enumeration date
09/05/2008
Last updated
02/07/2023
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