| Edda Mcmanus Lcsw Llc | |
|
567 Vauxhall Street Ext Suite 314 Waterford CT 06385-4330 | |
| (860) 440-3838 | |
| (860) 381-5099 |
| Full Name | Edda Mcmanus Lcsw Llc |
|---|---|
| Speciality | Social Worker |
| Location | 567 Vauxhall Street Ext, Waterford, Connecticut |
| Authorized Official Name and Position | Edda Mcmanus (OWNER) |
| Authorized Official Contact | 8604403838 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edda Mcmanus Lcsw Llc 567 Vauxhall Street Ext Suite 314 Waterford CT 06385-4330 Ph: (860) 440-3838 | Edda Mcmanus Lcsw Llc 567 Vauxhall Street Ext Suite 314 Waterford CT 06385-4330 Ph: (860) 440-3838 |
| NPI Number | 1619303047 |
|---|---|
| Provider Enumeration Date | 09/17/2013 |
| Last Update Date | 09/17/2013 |
| Medicare PECOS PAC ID | 2961725452 |
|---|---|
| Medicare Enrollment ID | O20150109000080 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619303047 | NPI | - | NPPES |
| CBHP004254 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 007169 (Connecticut) | Primary |
| Provider Name | Edda H Mcmanus |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871829804 PECOS PAC ID: 8224179064 Enrollment ID: I20091231000005 |
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