Individual
BISRAT ABEBE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LICSW
Contact information
Practice address
336 N MAIN ST, WEST HARTFORD, CT 06117-2675
(860) 696-4400
Mailing address
336 N MAIN ST, WEST HARTFORD, CT 06117-2675
(860) 696-4400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
10900
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10900
CT LICENSE
CT
Enumeration date
12/28/2006
Last updated
02/17/2020
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