Provider Demographics
NPI:1881083509
Name:TATRO, ALISSA (LCSW)
Entity type:Individual
Prefix:
First Name:ALISSA
Middle Name:
Last Name:TATRO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALISSA
Other - Middle Name:
Other - Last Name:PIASCIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:51 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06702-1545
Mailing Address - Country:US
Mailing Address - Phone:203-574-4000
Mailing Address - Fax:203-574-4003
Practice Address - Street 1:51 N ELM ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-1545
Practice Address - Country:US
Practice Address - Phone:203-574-4000
Practice Address - Fax:203-574-4003
Is Sole Proprietor?:No
Enumeration Date:2015-01-19
Last Update Date:2016-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT88891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical