Provider Demographics
NPI:1265573406
Name:LAUDETTE, SYLVIA J (MSW)
Entity type:Individual
Prefix:
First Name:SYLVIA
Middle Name:J
Last Name:LAUDETTE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 CASE ST STE 301
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06360-2222
Mailing Address - Country:US
Mailing Address - Phone:860-884-5980
Mailing Address - Fax:860-934-7984
Practice Address - Street 1:12 CASE ST STE 301
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2222
Practice Address - Country:US
Practice Address - Phone:860-884-5980
Practice Address - Fax:860-889-2658
Is Sole Proprietor?:No
Enumeration Date:2007-02-09
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004040689Medicaid