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Organization

LINDA S MITTENTHAL LCSW LLC

Active
Parent organization
LINDA S MITTENTHAL LCSW LLC
Other names
Linda S Mittenthal LCSW LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
LINDA S MITTENTHAL LCSW LLC
Authorized official
LINDA SUSAN MITTENTHAL LCSW (SOLE PROPRIETOR)
(860) 517-6633
Entity
Organization

Contact information

Practice address
1738 ELLINGTON RD, SOUTH WINDSOR, CT 06074-2773
(860) 614-0842
Mailing address
1738 ELLINGTON RD, SOUTH WINDSOR, CT 06074-2773
(860) 614-0842

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
251S00000X
Community/Behavioral Health Agency

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008034075
CT
01
11590385
CAQH
CT
Enumeration date
09/25/2019
Last updated
09/25/2019
About Stedi
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  • Eligibility checks
  • EDI platform