Individual
MISS SAVANA LOURDES FERNANDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW,BA,LMSW
Contact information
Practice address
72 WEST ST, DANBURY CLINICAL SERVICES, DANBURY, CT 06810-6531
(203) 797-9778
(203) 797-9858
Mailing address
141 E MAIN ST, 4TH FLOOR ADMINISTRATION, WATERBURY, CT 06702-2310
(203) 574-9000
(203) 574-9006
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1584
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008060589
—
CT
01
—
060669107
UBH-UNITED HEALTHCARE WELLMORE GRP/FACILITY
CT
01
—
136468979
CAQH
CT
01
—
D339227-DANBURY
VALUE OPTIONS
CT
01
—
NOT ELIGIBLE
MHN TRICARE NORTH
CT
01
—
PENDING
CIGNA BEHAVIORAL HEALTH
CT
Enumeration date
03/21/2012
Last updated
08/25/2016
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