Anna Ebora, LCSW
Individual provider Active NPI Clinical Social Worker · Mansfield Center, CT
NPI 1124575006 · NPPES record last updated May 16, 2020
Key facts
- NPI
- 1124575006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 11025 (CT)
- Practice address
- 189 Storrs Rd
Mansfield Center, CT 06250-1683 - Phone
- (860) 465-5922
- Fax
- (860) 456-1164
- NPI assigned
- Sep 8, 2016
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11025 | CT | MD | Physical Therapist |
Interoperability endpoints
- annaf.ebora@xdr.hhchealthdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Clinical Social Worker | 1041C0700X | 11025 | CT | Yes |
Addresses
Primary practice location
189 Storrs Rd
Mansfield Center, CT 06250-1683
Mailing address
123 Beverly Rd
West Hartford, CT 06119-1712
Phone (860) 268-0227
Other practice location 1
140 High St
Suite 230
Springfield, MA 01199-1006
Phone (413) 495-1500
Other providers in Mansfield Center, CT
- Stanley Paul Dugan
- Karen V Duhamel
- Katherine Ann Dunn
- Cindy Dupointe
- Autumn Dwy
- Naushad Ratan Edibam
- Inge-Marie Eigsti
- Claire Ellerbrock
- Craig Russell Elliott
- Sherri Anne Ericksen
All providers in Mansfield Center, 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 May 16, 2020. 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.