Provider Demographics
NPI:1477946176
Name:BOLANDER, ARICA L (LCSW)
Entity type:Individual
Prefix:
First Name:ARICA
Middle Name:L
Last Name:BOLANDER
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 1:360 FOUNTAIN ST
Mailing Address - Street 2:UNIT 10
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2609
Mailing Address - Country:US
Mailing Address - Phone:203-584-7422
Mailing Address - Fax:
Practice Address - Street 1:1062 BARNES RD
Practice Address - Street 2:SUITE 106
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-6012
Practice Address - Country:US
Practice Address - Phone:203-584-7422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-05
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0087501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical