Serena Eldredge

Individual provider Active NPI Social Worker · Westbrook, CT

NPI 1114735446 · NPPES record last updated Dec 19, 2024

Key facts

NPI
1114735446
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
10463 (CT)
Practice address
4 Grove Beach Rd N Ste 4
Westbrook, CT 06498-1656
Phone
(860) 437-4550
NPI assigned
Dec 19, 2024
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)
No

State licenses

LicenseStateTypeSpecialty
10463CTMDPsychiatric/Mental Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 10463 CT Yes

Addresses

Primary practice location

4 Grove Beach Rd N Ste 4
Westbrook, CT 06498-1656

Mailing address

PO Box 120
New London, CT 06320-0120
Phone (860) 437-4550

Other providers in Westbrook, CT

All providers in Westbrook, CT · Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.