Provider Demographics
NPI:1629733472
Name:HANOCK, CHELSEA (LMSW)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:
Last Name:HANOCK
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SILVER SPRING PARK
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-5622
Mailing Address - Country:US
Mailing Address - Phone:860-866-6390
Mailing Address - Fax:
Practice Address - Street 1:60 PALMERS HILL RD
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2113
Practice Address - Country:US
Practice Address - Phone:860-866-6390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-06
Last Update Date:2021-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5791104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker