Henrietta Small
Individual provider Active NPI Clinical Social Worker · New Preston, CT
NPI 1104228683 · NPPES record last updated Sep 16, 2014
Key facts
- NPI
- 1104228683
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 007349 (CT)
- Practice address
- 72 Mygatt Rd
New Preston, CT 06777-1610 - Phone
- (860) 729-3952
- NPI assigned
- Sep 16, 2014
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 007349 | CT | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 007349 | CT | Yes |
Addresses
Primary practice location
72 Mygatt Rd
New Preston, CT 06777-1610
Mailing address
72 Mygatt Rd
New Preston, CT 06777-1610
Phone (860) 729-3952
Other providers in New Preston, CT
- Pauline A Miller
- New Preston Dermatology, LLC
- Robert Edward O'Keefe
- Psychotherapy Care, LLC
- Robert E. Kane OD
- Joseph E Struckus
- Brent Denman Wainwright
All providers in New Preston, CT · Clinical Social Worker in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 16, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.