Provider Demographics
NPI:1619001054
Name:PRETE, ELIZABETH R (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:PRETE
Suffix:
Gender:F
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:P.O. BOX 3003
Mailing Address - Street 2:
Mailing Address - City:STONY CREEK
Mailing Address - State:CT
Mailing Address - Zip Code:06405-1603
Mailing Address - Country:US
Mailing Address - Phone:203-494-1414
Mailing Address - Fax:203-481-5291
Practice Address - Street 1:730 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405
Practice Address - Country:US
Practice Address - Phone:203-494-1414
Practice Address - Fax:203-481-5291
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000529CT1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT4179968Medicaid
140000529CT01OtherANTHEM BLUE CROSS BLUE SH
108476OtherVALUE OPTIONS
199616OtherMHN