Provider Demographics
NPI:1467524348
Name:LORENZETTI, THOMAS A (LCSW)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:A
Last Name:LORENZETTI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 RUSSELL ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06052-1312
Mailing Address - Country:US
Mailing Address - Phone:860-229-8887
Mailing Address - Fax:860-229-8886
Practice Address - Street 1:COMMUNITY MENTAL HEALTH AFFILIATES, INC.
Practice Address - Street 2:55 WINTHROP STREET
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06052
Practice Address - Country:US
Practice Address - Phone:860-224-8192
Practice Address - Fax:860-827-3472
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0063281041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1942393814Medicaid
CT006328OtherLCSW LICENSE NUMBER
CT1992896005Medicaid
1174624423OtherCMHA FACILITY NPI
CT1992896005Medicaid