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Individual

MR. DARYN SCOTT TENENBAUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LCSW

Contact information

Practice address
107 PROVIDENCE ST, PUTNAM, CT 06260
(860) 963-2658
(860) 963-2658
Mailing address
107 PROVIDENCE ST, PO BOX 84, PUTNAM, CT 06260
(860) 963-2658
(860) 963-2658

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
004608
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
140004608CT01
ANTHEMBCBS
CT
01
164693
HEALTHNET
CT
01
2686-8
BCBS OF RI
RI
01
412176
BLUECHIP
RI
01
P2543702
OXFORD
CT
Enumeration date
09/15/2006
Last updated
07/08/2007
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