| Michelle Marie Wortham, LCSW | |
|
171 Market Sq Ste 206a, Newington, CT 06111-2930 | |
| (860) 845-1503 | |
| Not Available |
| Full Name | Michelle Marie Wortham |
|---|---|
| Gender | Female |
| Speciality | Clinical Social Worker |
| Experience | 13 Years |
| Location | 171 Market Sq Ste 206a, Newington, Connecticut |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316584956 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 10836 (Connecticut) | Primary |
| Entity Name | New Provenance Counseling Center, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1457949687 PECOS PAC ID: 3476934126 Enrollment ID: O20220713001166 |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle Marie Wortham, LCSW 171 Market Sq Ste 206a, Newington, CT 06111-2930 Ph: (860) 845-1503 | Michelle Marie Wortham, LCSW 171 Market Sq Ste 206a, Newington, CT 06111-2930 Ph: (860) 845-1503 |
Jadien Londin Smith, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1632 Willard Ave, Newington, CT 06111 Phone: 860-810-4868 | |
Shioban Natassia Gordon, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1268 Main St Ste 204, Newington, CT 06111 Phone: 860-785-6222 | |
Ms. Adrienne Benjamin, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1268 Main St, Suite 101, Newington, CT 06111 Phone: 860-667-9498 Fax: 860-667-2408 | |
Mr. Vincent Michael Sapone, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 74 Edmund St, Newington, CT 06111 Phone: 860-505-5300 | |
Jenna Jorel, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 110 Stonehedge Dr, Newington, CT 06111 Phone: 860-810-1955 | |
Joanna Ahern, Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 413 Cedar St, Newington, CT 06111 Phone: 347-744-7086 | |
Shatona Harrison, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 555 Willard Ave, Newington, CT 06111 Phone: 860-849-6332 |