Provider Demographics
NPI:1790862399
Name:ANELLO, MICHAEL K (LCSW)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:K
Last Name:ANELLO
Suffix:
Gender:M
Credentials:LCSW
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Other - Credentials:
Mailing Address - Street 1:55 WEST MAIN STREET
Mailing Address - Street 2:WESTERN CONNECTICUT MENTAL HEALTH NETWORK SUITE 410
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702
Mailing Address - Country:US
Mailing Address - Phone:203-805-6408
Mailing Address - Fax:203-805-6432
Practice Address - Street 1:55 WEST MAIN STREET
Practice Address - Street 2:WESTERN CONNECTICUT MENTAL HEALTH NETWORK SUITE 410
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702
Practice Address - Country:US
Practice Address - Phone:203-805-6408
Practice Address - Fax:203-805-6432
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0048261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical