Provider Demographics
NPI:1265955272
Name:ADLER, EILEEN ANN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:EILEEN
Middle Name:ANN
Last Name:ADLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EILEEN
Other - Middle Name:ANN
Other - Last Name:O'CONNOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3 BROWNLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-1438
Mailing Address - Country:US
Mailing Address - Phone:860-232-5159
Mailing Address - Fax:
Practice Address - Street 1:155 RAFFIA RD
Practice Address - Street 2:
Practice Address - City:ENFIELD
Practice Address - State:CT
Practice Address - Zip Code:06082-5691
Practice Address - Country:US
Practice Address - Phone:860-253-5447
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-21
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0047641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical