Organization
EDDA MCMANUS LCSW LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDA MCMANUS LCSW (OWNER)
(860) 440-3838
Entity
Organization
Contact information
Practice address
567 VAUXHALL STREET EXT, SUITE 314, WATERFORD, CT 06385-4330
(860) 440-3838
(860) 381-5099
Mailing address
567 VAUXHALL STREET EXT, SUITE 314, WATERFORD, CT 06385-4330
(860) 440-3838
(860) 381-5099
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
007169
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CBHP004254
—
CT
Enumeration date
09/17/2013
Last updated
09/17/2013
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