Provider Demographics
NPI:1902205875
Name:SHKRELI, MARIA ELISA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ELISA
Last Name:SHKRELI
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 1:71 CASTLE DR
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-2933
Mailing Address - Country:US
Mailing Address - Phone:203-443-7300
Mailing Address - Fax:203-549-0959
Practice Address - Street 1:71 CASTLE DR
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-2933
Practice Address - Country:US
Practice Address - Phone:203-443-7300
Practice Address - Fax:203-549-0959
Is Sole Proprietor?:No
Enumeration Date:2014-08-17
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical