Sherida Antonacci, LCSW

Individual provider Active NPI Clinical Social Worker · Norwich, CT

NPI 1669670451 · NPPES record last updated Mar 24, 2010

Key facts

NPI
1669670451
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
Practice address
331 Main St
Norwich, CT 06360-5836
Phone
(860) 889-8346
Fax
(860) 889-2658
NPI assigned
Jul 3, 2007
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)
Yes

State licenses

LicenseStateTypeSpecialty
7077CTMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Yes

Addresses

Primary practice location

331 Main St
Norwich, CT 06360-5836

Mailing address

199 S Main St
Marlborough, CT 06447-1504
Phone (860) 295-9306

Other providers in Norwich, CT

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

Sources for this page

Verify at the official NPI Registry.