Lissette Betancourt
Individual provider Active NPI Clinical Social Worker · New Milford, CT
NPI 1205549474 · NPPES record last updated Jan 3, 2023
Key facts
- NPI
- 1205549474
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 3031 (CT)
- Practice address
- 29 Carmen Hill Rd # 1
New Milford, CT 06776-4509 - Phone
- (646) 262-2778
- NPI assigned
- Jan 3, 2023
- 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
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 3031 | CT | Yes |
Addresses
Primary practice location
29 Carmen Hill Rd # 1
New Milford, CT 06776-4509
Mailing address
29 Carmen Hill Rd # 1
New Milford, CT 06776-4509
Phone (646) 262-2778
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 3, 2023. 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.