Provider Demographics
NPI:1619299484
Name:ESTES, VANIA MARISIA (MSW,LMSW)
Entity Type:Individual
Prefix:MRS
First Name:VANIA
Middle Name:MARISIA
Last Name:ESTES
Suffix:
Gender:F
Credentials:MSW,LMSW
Other - Prefix:MS
Other - First Name:VANIA
Other - Middle Name:MARISIA
Other - Last Name:AVELINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:141 E MAIN ST
Mailing Address - Street 2:4TH FLOOR ADMINISTRATION
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-2310
Mailing Address - Country:US
Mailing Address - Phone:203-574-9000
Mailing Address - Fax:203-574-9006
Practice Address - Street 1:141 E MAIN ST
Practice Address - Street 2:HOME BASED SERVICES 3RD FLOOR
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2310
Practice Address - Country:US
Practice Address - Phone:203-575-0466
Practice Address - Fax:203-574-1817
Is Sole Proprietor?:No
Enumeration Date:2010-02-22
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000528104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT13531222OtherCAQH
CT008056883Medicaid
CT13531222OtherCAQH
CT060669107OtherANTHEM BCBS OF CT WELLMORE GRP/FACILICY
CT060669107OtherUBH-CONNECTICARE WELLMORE GRP/FACILITY
CT060669107OtherHEALTHYCT WELLMORE GRP/FACILITY
CTD339209 WTBY 141OtherVALUE OPTIONS
CT060669107OtherUBH-UNITED HEALTHCARE
CT060669107OtherUNITED BEHAVIORAL HEALTH WELLMORE GRP/FACILITY
CTNOT ELIGIBLEOtherMHN MANAGED HEALTH NETWORK
CTNOT ELIGIBLEMedicare PIN
CT060669107OtherUBH-OXFORD HEALTH FREEDOM/LIBERTY WELLMORE GRP/FACILITY
CTPENDINGOtherAETNA BEHAVIORAL HEALTH
CT008056883Medicaid