Provider Demographics
NPI:1669797247
Name:MANELA, EILEEN MAE (LCSW)
Entity type:Individual
Prefix:MS
First Name:EILEEN
Middle Name:MAE
Last Name:MANELA
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 1:19 BLAKESLEE ROAD
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-3822
Mailing Address - Country:US
Mailing Address - Phone:860-782-9919
Mailing Address - Fax:860-782-9919
Practice Address - Street 1:7 WEST STREET
Practice Address - Street 2:SUITE #26
Practice Address - City:LITCHFIELD
Practice Address - State:CT
Practice Address - Zip Code:06759-3822
Practice Address - Country:US
Practice Address - Phone:860-782-9919
Practice Address - Fax:860-782-9919
Is Sole Proprietor?:No
Enumeration Date:2010-04-07
Last Update Date:2010-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006480104100000X
NYR035042-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker