Provider Demographics
NPI:1245934009
Name:GOMES, CELINA (LCSW)
Entity type:Individual
Prefix:
First Name:CELINA
Middle Name:
Last Name:GOMES
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 1:21 STILL HILL RD
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-1822
Mailing Address - Country:US
Mailing Address - Phone:203-560-7958
Mailing Address - Fax:
Practice Address - Street 1:21 STILL HILL RD
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-1822
Practice Address - Country:US
Practice Address - Phone:203-560-7958
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC240491041C0700X
CT56221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical