Vankeuren Maldonado, Beth C
Vankeuren Maldonado, Beth C is an sole proprietor health care provider with primary practice located at 130 Division St , Derby CT 06418-1326. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Vankeuren Maldonado, Beth C can be contacted via phone (203) 732-7474.Contact Information
Primary practice address
130 Division St
Derby CT 06418-1326
Phone: (203) 732-7474
Fax: (203) 735-1550
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 005811 | Connecticut |
Profile Details
| NPI number | 1346261153 |
|---|---|
| LBN Legal business name | Vankeuren Maldonado, Beth C |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Jan 31st, 2013 - about 12 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 | 1346261153 | NPPES |
| Connecticut | MEDICAID | 004039244 | |
| Connecticut | Other | 318983 |
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