Organization
ELATION WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARIA CAMILA SMITH LCSW (CLINICIAN)
(203) 308-7835
Entity
Organization
Contact information
Practice address
1057 BROAD ST, BRIDGEPORT, CT 06604-4219
(860) 661-2925
Mailing address
248 TOBY HILL RD, WESTBROOK, CT 06498-3521
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004235918
—
CT
Enumeration date
08/22/2016
Last updated
04/02/2018
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