Steven Ambrico, LCSW

Individual provider Active NPI Clinical Social Worker · Groton, CT

NPI 1548634876 · NPPES record last updated Jan 22, 2025

Key facts

NPI
1548634876
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
010156 (CT)
Practice address
1 Wahoo Dr
Sarp
Groton, CT 06349
Phone
(860) 694-4021
NPI assigned
Nov 24, 2015
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
82741CAMDClinical Social Worker
010156CTMDClinical Social Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X
Clinical Social Worker 1041C0700X 82741 CA
Clinical Social Worker 1041C0700X 010156 CT Yes

Addresses

Primary practice location

1 Wahoo Dr
Sarp
Groton, CT 06349

Mailing address

1 Wahoo Dr
Sarp
Groton, CT 06349
Phone (860) 694-4021

Other providers in Groton, CT

All providers in Groton, CT · Clinical Social Worker in Connecticut

Sources for this page

Verify at the official NPI Registry.