Individual
DIANA POTWARDOWSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
184 FRONT AVE, WEST HAVEN, CT 06516-2836
(203) 781-4600
(203) 781-4624
Mailing address
1 LONG WHARF DR, SUITE 321, NEW HAVEN, CT 06511-5946
(203) 781-4600
(203) 781-4624
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9633
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008069472
POTWARDOWSKI MEDICAID #
CT
Enumeration date
11/28/2016
Last updated
01/24/2022
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