Nilsson, Samantha Lynne

Nilsson, Samantha Lynne is an individual health care provider with primary practice located at 51 N Elm St , Waterbury CT 06702-1545. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Community Health Worker, Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Nilsson, Samantha Lynne can be contacted via phone (203) 574-4000.

Contact Information

Primary practice address
51 N Elm St Waterbury CT 06702-1545
Phone: (203) 574-4000
Fax: (203) 574-4003
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X Connecticut
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Clinical 1041C0700X 008703 Connecticut

Profile Details

NPI number 1023314796
LBN Legal business name Nilsson, Samantha Lynne
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 28th, 2011
Last updated Sep 5th, 2023 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023314796 NPPES
Connecticut MEDICAID 008057448

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