Leichtberg, Judith
Leichtberg, Judith is an sole proprietor health care provider with primary practice located at 1301 Farmington Ave , Farmington CT 06032. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Leichtberg, Judith can be contacted via phone (860) 677-2550.Contact Information
Primary practice address
1301 Farmington Ave
Farmington CT 06032
Phone: (860) 677-2550
Fax: (860) 677-4975
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 003489 | Connecticut |
Profile Details
| NPI number | 1003875758 |
|---|---|
| LBN Legal business name | Leichtberg, Judith |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 21st, 2006 |
| Last updated | Dec 17th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003875758 | NPPES |
| Connecticut | Other | 211793 | MANAGED HEALTH NET |
| Connecticut | Other | 140003489CT04 | MANAGED HEALTH NET |
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