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MS. SAMANTHA ACANFORA LCSW
Clinical >> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1447775135
Individual Registrant:MS. SAMANTHA ACANFORA LCSW
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
226 DIXWELL AVENUE NORTHSIDE COMMUNITY OUTPATIENT SERVICES NEW HAVEN, CT 06511-3456 US
Tel: 203-503-3470 Fax: 203-503-3478
Tel: 203-503-3470 Fax: 203-503-3478
Contact information for business:
PO BOX 7720 CREDENTIALING SPECIALIST NEW HAVEN, CT 06519-0720 US
Tel: 203-503-3174 Fax: 203-503-3183
Tel: 203-503-3174 Fax: 203-503-3183
Registration Information:
NPI: 1447775135
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker Clinical | CT | 10704 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 008089584 | CT | 05 |
